Provider Demographics
NPI:1154486678
Name:AJAY K, MASIH, M.D., INC.
Entity Type:Organization
Organization Name:AJAY K, MASIH, M.D., INC.
Other - Org Name:CENTER FOR SPINE AND SPORTS REHABILITATION MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MASIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-553-0123
Mailing Address - Street 1:2080 CENTURY PARK E STE 1501
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2018
Mailing Address - Country:US
Mailing Address - Phone:310-553-0123
Mailing Address - Fax:
Practice Address - Street 1:2080 CENTURY PARK E STE 1501
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2018
Practice Address - Country:US
Practice Address - Phone:310-553-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64040208100000X, 2081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17115Medicare ID - Type Unspecified
H20586Medicare UPIN