1497718878 NPI number — DR. ARA E. KALLIBJIAN D.P.M.

Table of content: MELINDA SOTO LMT (NPI 1548048929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497718878 NPI number — DR. ARA E. KALLIBJIAN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALLIBJIAN
Provider First Name:
ARA
Provider Middle Name:
E.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497718878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 74637
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44194-4637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-743-2525
Provider Business Mailing Address Fax Number:
440-743-2526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6115 POWERS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44129-5471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-743-2525
Provider Business Practice Location Address Fax Number:
440-743-2526
Provider Enumeration Date:
04/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  36002424 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0688377 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2700183 . This is a "UNITEDHEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341687195027 . This is a "CARESOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000167332 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 366732233011 . This is a "MEDICAL MUTUAL" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com