Provider Demographics
NPI:1790739191
Name:GOLUBEVA-GANELES, ARINA D (MD)
Entity Type:Individual
Prefix:
First Name:ARINA
Middle Name:D
Last Name:GOLUBEVA-GANELES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ARINA
Other - Middle Name:D
Other - Last Name:GANELES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 CASS ST. SUITE 128
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-920-3222
Mailing Address - Fax:831-920-3245
Practice Address - Street 1:700 CASS ST. SUITE 128
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-920-3222
Practice Address - Fax:831-920-3245
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77100207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ13460ZOtherMEDICARE GROUP#
CA00A771000Medicaid
CAGR0080140OtherMEDICAID GROUP #
CAGR0080140OtherMEDICAID GROUP #
CA00A771000Medicaid