Provider Demographics
NPI:1770799629
Name:ARTA WESTERN CALIFORNIA, INC.
Entity type:Organization
Organization Name:ARTA WESTERN CALIFORNIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIETHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-205-6262
Mailing Address - Street 1:3333 MICHELSON DR
Mailing Address - Street 2:SUITE 735
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-0625
Mailing Address - Country:US
Mailing Address - Phone:949-260-6500
Mailing Address - Fax:949-833-3736
Practice Address - Street 1:3333 MICHELSON DR
Practice Address - Street 2:SUITE 735
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-0625
Practice Address - Country:US
Practice Address - Phone:949-260-6500
Practice Address - Fax:949-833-3736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization