Provider Demographics
NPI:1982931853
Name:BAKSHANDEH, ARTA (DO)
Entity Type:Individual
Prefix:DR
First Name:ARTA
Middle Name:
Last Name:BAKSHANDEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W TOWN AND COUNTRY RD
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4600
Mailing Address - Country:US
Mailing Address - Phone:844-310-2247
Mailing Address - Fax:
Practice Address - Street 1:6201 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:EAST LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4505
Practice Address - Country:US
Practice Address - Phone:844-310-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10961207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine