Provider Demographics
NPI:1447366018
Name:SOGHOMONIAN, ARA KARNIK (MD)
Entity type:Individual
Prefix:DR
First Name:ARA
Middle Name:KARNIK
Last Name:SOGHOMONIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2086 W ALLUVIAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-7166
Mailing Address - Country:US
Mailing Address - Phone:559-436-0484
Mailing Address - Fax:559-261-0596
Practice Address - Street 1:2645 MERCED ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1302
Practice Address - Country:US
Practice Address - Phone:559-264-8642
Practice Address - Fax:559-485-9526
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50159208M00000X, 207PE0004X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000A5015Medicaid
5873326OtherPIN
CA2185927OtherMEDICAL PIN
5873326OtherPIN
CA2185927OtherMEDICAL PIN
CA00A501590Medicare PIN