Provider Demographics
NPI:1659422558
Name:ASCHA, OSSAMA DEAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:OSSAMA
Middle Name:DEAYA
Last Name:ASCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:350 VINTON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3000
Mailing Address - Country:US
Mailing Address - Phone:909-629-6417
Mailing Address - Fax:909-629-4755
Practice Address - Street 1:350 VINTON AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3000
Practice Address - Country:US
Practice Address - Phone:909-629-6417
Practice Address - Fax:909-629-4755
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26396208200000X, 208600000X
HI12249208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A83386Medicare UPIN