Provider Demographics
NPI:1750579587
Name:MITTAL, ARUN K (MD)
Entity type:Individual
Prefix:MR
First Name:ARUN
Middle Name:K
Last Name:MITTAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:21350 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5605
Mailing Address - Country:US
Mailing Address - Phone:310-792-5428
Mailing Address - Fax:310-792-5358
Practice Address - Street 1:21350 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5605
Practice Address - Country:US
Practice Address - Phone:310-792-5428
Practice Address - Fax:310-792-5358
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
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Provider Licenses
StateLicense IDTaxonomies
CAA246912086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A246910Medicaid
CA00A246910Medicaid
CAA24691Medicare PIN