Provider Demographics
NPI:1952407983
Name:HEIDARI, ARASH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:HEIDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARASH
Other - Middle Name:
Other - Last Name:HEIDARI-FOROUSHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3838 SAN DIMAS ST STE A100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2286
Practice Address - Country:US
Practice Address - Phone:661-327-8538
Practice Address - Fax:661-327-5432
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81842207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A818420Medicaid
CA00A818420Medicaid