Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 105170 | MN |
N | 207Q00000X | Family Doctor | 11538 | NV |
N | 207Q00000X | Family Doctor | 13858 | ND |
NPI | 1003816554 |
---|---|
Provider Name | Ali Reza Arbabi |
First Address | Hutchinson, MN 55350 |
Second Address | Hutchinson, MN 55350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 28/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100507696 | (05) | NV |
100507697 | (05) | NV |
I41548 | (02) |