Basic Information
Provider Information
NPI: 1487910774
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMINI
FirstName: ARYA
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 512185
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90051
CountryCode: US
TelephoneNumber: 6267753514
FaxNumber:  
Practice Location
Address1: 1500 E. DUARTE ROAD
Address2:  
City: DUARTE
State: CA
PostalCode: 91010
CountryCode: US
TelephoneNumber: 6262564673
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/11/2012
LastUpdateDate: 11/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XTL.0004795CON Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
2085R0001XA148496CAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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