1922143791 NPI number — DR. HERBERT AARON ERADAT M.D., M.S.

Table of content: DR. HERBERT AARON ERADAT M.D., M.S. (NPI 1922143791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922143791 NPI number — DR. HERBERT AARON ERADAT M.D., M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERADAT
Provider First Name:
HERBERT
Provider Middle Name:
AARON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., M.S.
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:
1922143791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 SANTA MONICA BLVD STE 600
Provider Second Line Business Mailing Address:
UCLA HEMATOLOGY ONCOLOGY
Provider Business Mailing Address City Name:
SANTA MONICA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90404-2131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-633-8400
Provider Business Mailing Address Fax Number:
310-206-6759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10945 LE CONTE AVE
Provider Second Line Business Practice Location Address:
2333 PVUB
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-6301
Provider Business Practice Location Address Fax Number:
310-206-6759
Provider Enumeration Date:
02/20/2007

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: 207R00000X , with the licence number:  A87471 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00A874710 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com