Provider Demographics
NPI:1144656430
Name:ARAQUE TRIANA, KATHERINE ANDREA (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANDREA
Last Name:ARAQUE TRIANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 AVALON DR W
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3678
Mailing Address - Country:US
Mailing Address - Phone:475-227-9367
Mailing Address - Fax:
Practice Address - Street 1:2125 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1337
Practice Address - Country:US
Practice Address - Phone:310-829-8751
Practice Address - Fax:310-315-6113
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD043994207RE0101X
390200000X
CAA162957207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program