Provider Demographics
NPI:1700964871
Name:JAIN, ARUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11911 ARTESIA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4065
Mailing Address - Country:US
Mailing Address - Phone:562-239-2240
Mailing Address - Fax:562-286-8080
Practice Address - Street 1:11911 ARTESIA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90701-4065
Practice Address - Country:US
Practice Address - Phone:562-239-2240
Practice Address - Fax:562-286-8080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG80467207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G804670Medicaid
CA00G804670Medicaid
00G804670Medicare ID - Type Unspecified