Provider Demographics
NPI:1740251693
Name:KESHISHIAN, ARA (MD)
Entity type:Individual
Prefix:DR
First Name:ARA
Middle Name:
Last Name:KESHISHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CONGRESS ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3027
Mailing Address - Country:US
Mailing Address - Phone:818-812-7222
Mailing Address - Fax:818-952-0990
Practice Address - Street 1:10 CONGRESS ST STE 300
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3027
Practice Address - Country:US
Practice Address - Phone:818-812-7222
Practice Address - Fax:818-952-0990
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA559040208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG80795Medicare UPIN
CA00A559040Medicare ID - Type Unspecified