Provider Demographics
NPI:1861495475
Name:KASHYAP, ASHWIN (MD)
Entity type:Individual
Prefix:DR
First Name:ASHWIN
Middle Name:
Last Name:KASHYAP
Suffix:
Gender:M
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 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 HAALAND DR STE 101
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-5230
Practice Address - Country:US
Practice Address - Phone:805-496-2949
Practice Address - Fax:805-204-4076
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52406207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1417145673Medicaid
CA1861495475Medicaid
CA1417145673Medicaid
CA1861495475Medicaid