Basic Information
| Provider Information | |||||||||
| NPI: | 1003816554 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARBABI | ||||||||
| FirstName: | ALI | ||||||||
| MiddleName: | REZA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ARBABI | ||||||||
| OtherFirstName: | ALIREZA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1095 HWY 15 S | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202345000 | ||||||||
| FaxNumber: | 3204844686 | ||||||||
| Practice Location | |||||||||
| Address1: | 1095 HWY 15 S | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202345000 | ||||||||
| FaxNumber: | 3204844686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2005 | ||||||||
| LastUpdateDate: | 12/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MN-53531 | MN | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 11538 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 105170 | MN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 13858 | ND | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100507697 | 05 | NV | MEDICAID | 100507696 | 05 | NV | MEDICAID |