Provider Demographics
NPI:1922018993
Name:ARIAS, EDWARD JAMES (PA)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAMES
Last Name:ARIAS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 HOSPITAL DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5406
Mailing Address - Country:US
Mailing Address - Phone:916-689-6160
Mailing Address - Fax:916-689-3711
Practice Address - Street 1:7600 HOSPITAL DR
Practice Address - Street 2:SUITE H
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5406
Practice Address - Country:US
Practice Address - Phone:916-689-6160
Practice Address - Fax:916-689-3711
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16102363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA16102OtherSTATE LICENSE
CAPA16102OtherSTATE LICENSE