Provider Demographics
NPI:1669914966
Name:MEISAMI, ARASH
Entity type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:MEISAMI
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 1:3138 NEWTON ST APT 404F
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6728
Mailing Address - Country:US
Mailing Address - Phone:310-483-8765
Mailing Address - Fax:
Practice Address - Street 1:3138 NEWTON ST APT 404F
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6728
Practice Address - Country:US
Practice Address - Phone:310-483-8765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABL-LIC-033706343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)