Provider Demographics
NPI:1508892522
Name:MASIH, SULABHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SULABHA
Middle Name:
Last Name:MASIH
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:PO BOX 31399
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:STE 1600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG169352085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A305190G56OtherCAL OPTIMA
CAP00059899OtherRAIL ROAD MEDICARE
CA00A305190OtherBLUE SHIELD
CA00A305190Medicaid
CAWA30519CMedicare PIN
CAWA30519EMedicare PIN
CA00A305190OtherBLUE SHIELD
CAP00059899OtherRAIL ROAD MEDICARE
CA00A305190G56OtherCAL OPTIMA
CAWA30519FMedicare PIN