Provider Demographics
NPI:1659566875
Name:LIVHITS, MASHA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MASHA
Middle Name:J
Last Name:LIVHITS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 UCLA MEDICAL PLZ STE 310
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6999
Practice Address - Country:US
Practice Address - Phone:310-267-7838
Practice Address - Fax:310-267-8632
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA103993208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659566875Medicaid
CACB214054Medicare PIN