Provider Demographics
| NPI: | 1801018478 |
|---|---|
| Name: | SAHAKIAN, ARA (MD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | ARA |
| Middle Name: | |
| Last Name: | SAHAKIAN |
| 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: | PO BOX 31309 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LOS ANGELES |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 90031-0309 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 323-442-5100 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1520 SAN PABLO ST |
| Practice Address - Street 2: | SUITE 1000 |
| Practice Address - City: | LOS ANGELES |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 90033-5310 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 323-442-5100 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2007-05-03 |
| Last Update Date: | 2020-12-02 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | A97441 | 207R00000X, 207RG0100X |
| CT | 50963 | 207RG0100X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | GR0100430 | Other | GROUP MEDI-CAL |
| CA | W18762 | Other | GROUP MEDICARE |
| CA | 1902846306 | Other | GROUP NPI |