Provider Demographics
NPI:1922116698
Name:ASKARI, ASGHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASGHAR
Middle Name:
Last Name:ASKARI
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 1:1360 W 6TH ST STE 160
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3537
Mailing Address - Country:US
Mailing Address - Phone:310-519-9180
Mailing Address - Fax:310-519-0225
Practice Address - Street 1:1360 W 6TH ST STE 160
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3537
Practice Address - Country:US
Practice Address - Phone:310-519-9180
Practice Address - Fax:310-519-0225
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A35822Medicaid
CAA35822Medicare PIN
CA00A35822Medicaid