Provider Demographics
NPI:1265744783
Name:SABAPATHY, THUSA (MD)
Entity type:Individual
Prefix:
First Name:THUSA
Middle Name:
Last Name:SABAPATHY
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 1:4650 SUNSET BLVD.,
Mailing Address - Street 2:MS#76 , DIVISION OF GENERAL PEDIATRICS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-361-6161
Mailing Address - Fax:
Practice Address - Street 1:4650 SUNSET BLVD.,
Practice Address - Street 2:MS#76 , DIVISION OF GENERAL PEDIATRICS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-361-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY61005390200000X
CAA125350390200000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program