Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A64040 | CA |
N | 2081P2900X | Pain Medicine | A64040 | CA |
N | 2081S0010X | Sports Medicine | A64040 | CA |
N | 213ES0000X | Sports Medicine | A64040 | CA |
NPI | 1013072537 |
---|---|
Provider Name | Ajay K. Masih |
First Address | Los Angeles, CA 90067 |
Second Address | Los Angeles, CA 90067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H20586 | (02) |