Provider Demographics
NPI:1942496211
Name:ARIANI, MEHRDAD KEVIN
Entity Type:Individual
Prefix:
First Name:MEHRDAD
Middle Name:KEVIN
Last Name:ARIANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18350 ROSCOE BL
Mailing Address - Street 2:#400
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325
Mailing Address - Country:US
Mailing Address - Phone:818-678-4900
Mailing Address - Fax:818-678-6610
Practice Address - Street 1:18350 ROSCOE BL
Practice Address - Street 2:#400
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325
Practice Address - Country:US
Practice Address - Phone:818-678-4900
Practice Address - Fax:818-678-6610
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48708207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A487080Medicaid
CAW21601Medicare PIN
CAE98485Medicare UPIN
CAHW13403AMedicare PIN
CAWA48708AMedicare PIN
CA00A487080Medicaid