Provider Demographics
NPI:1184924904
Name:ZAMANIAN, ARASH (MD)
Entity type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:ZAMANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 N 31ST AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9581
Mailing Address - Country:US
Mailing Address - Phone:602-997-2233
Mailing Address - Fax:602-997-2667
Practice Address - Street 1:10220 N 31ST AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9581
Practice Address - Country:US
Practice Address - Phone:602-997-2233
Practice Address - Fax:602-997-2667
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY259152174400000X
AZ445382084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ625665Medicaid