Provider Demographics
NPI:1023109766
Name:DAS, ASHA (MD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:DAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 BUNKER HILL ST
Mailing Address - Street 2:SUITE # 230
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5754
Mailing Address - Country:US
Mailing Address - Phone:858-336-0468
Mailing Address - Fax:
Practice Address - Street 1:3030 BUNKER HILL ST
Practice Address - Street 2:SUITE # 230
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5754
Practice Address - Country:US
Practice Address - Phone:858-336-0468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG861932084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology