Provider Demographics
NPI:1639315708
Name:KOHM, ALISHA DESAI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:DESAI
Last Name:KOHM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISHA
Other - Middle Name:NIKHIL
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2250 ALCAZAR ST
Mailing Address - Street 2:CSC 2200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-442-4001
Mailing Address - Fax:323-442-5555
Practice Address - Street 1:2250 ALCAZAR ST
Practice Address - Street 2:CSC 2200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-442-4001
Practice Address - Fax:323-442-5555
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANOT APPLICABLE2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry