Provider Demographics
NPI:1912365891
Name:ARYA MEDICAL GROUP CORP
Entity Type:Organization
Organization Name:ARYA MEDICAL GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-424-0610
Mailing Address - Street 1:1660 E HERNDON AVE
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3359
Mailing Address - Country:US
Mailing Address - Phone:559-424-0610
Mailing Address - Fax:559-424-0611
Practice Address - Street 1:1660 E HERNDON AVE
Practice Address - Street 2:SUITE # 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3359
Practice Address - Country:US
Practice Address - Phone:559-424-0610
Practice Address - Fax:559-424-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 207R00000X, 207RC0200X, 207RP1001X
CAA114143207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1912365891Medicaid