Provider Demographics
NPI:1992867329
Name:ARYAN, HENRY E (MD, FACS, FAANS)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:E
Last Name:ARYAN
Suffix:
Gender:M
Credentials:MD, FACS, FAANS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27245
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7245
Mailing Address - Country:US
Mailing Address - Phone:559-256-1030
Mailing Address - Fax:559-434-5742
Practice Address - Street 1:1630 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3305
Practice Address - Country:US
Practice Address - Phone:559-256-1030
Practice Address - Fax:559-434-5742
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76676207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A766761Medicare PIN