Provider Demographics
NPI:1801035514
Name:ARASH VAHDAT MD INC
Entity Type:Organization
Organization Name:ARASH VAHDAT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHDAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-665-2065
Mailing Address - Street 1:PO BOX 25946
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-0946
Mailing Address - Country:US
Mailing Address - Phone:818-665-2065
Mailing Address - Fax:
Practice Address - Street 1:18370 BURBANK BLVD STE 714
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2827
Practice Address - Country:US
Practice Address - Phone:818-665-2065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABQ198AMedicare PIN