1790953560 NPI number — LENA R AROUS M.D.

Table of content: LENA R AROUS M.D. (NPI 1790953560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790953560 NPI number — LENA R AROUS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AROUS
Provider First Name:
LENA
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABDUL-AHAD
Provider Other First Name:
LENA
Provider Other Middle Name:
RAMZI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790953560
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9602
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91346-9602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-837-5559
Provider Business Mailing Address Fax Number:
818-792-4793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26357 MCBEAN PKWY
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
VALENCIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-4488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-222-2605
Provider Business Practice Location Address Fax Number:
661-951-3192
Provider Enumeration Date:
02/14/2008

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:  MD0000046346 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: A124309 , 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: 46346 . This is a "MD LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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