Provider Demographics
NPI:1417957135
Name:CASHDAN, DONNA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:CASHDAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:FACSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4835 VAN NUYS BLVD
Mailing Address - Street 2:208
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2109
Mailing Address - Country:US
Mailing Address - Phone:818-981-9880
Mailing Address - Fax:818-981-9884
Practice Address - Street 1:4835 VAN NUYS BLVD
Practice Address - Street 2:208
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2109
Practice Address - Country:US
Practice Address - Phone:818-981-9880
Practice Address - Fax:818-650-2894
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59213Medicare UPIN
W20A6692AMedicare ID - Type Unspecified