DR. AJITA DEODHAR (NPI# 1740593458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740593458 |
| Entity Type | Individual |
| Full Name | DR. AJITA DEODHAR |
| Credential | M.D |
| Practice Address |
1520 San Pablo St Los Angeles CA 90033-5310 |
| Mailing Address |
Po Box 31309 Los Angeles CA 90031-0309 |
| Practice Telephone | 3234428541 |
| Practice Fax Number | 3234428755 |
| Mailing Telephone | 3234428541 |
| Mailing Fax Number | 3234428755 |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2014-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MT194299 | PA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
A116266 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
160765 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
1520 SAN PABLO ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90033-5310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891798765 | Usc Ppa, Inc. | Psychologist | 1520 San Pablo St, Ste 4100, Los Angeles, CA 90033-5316 | 2005-05-24 |
| 1922612126 | Cyryl R Celiz | Nurse Practitioner | 1520 San Pablo St, Los Angeles, CA 90033-5310 | 2020-09-04 |
| 1750995478 | Kathleen Kay Rosario | Nurse Practitioner | 1520 San Pablo St, Los Angeles, CA 90033-5310 | 2020-08-31 |
| 1154933281 | Joshua Tobe | Pain Medicine | 1520 San Pablo St, Los Angeles, CA 90033-5310 | 2020-08-19 |
| 1710484993 | Matthew Joseph Ashbrook | Surgery | 1520 San Pablo St, Los Angeles, CA 90033-5310 | 2018-04-12 |
| 1306377791 | Graham Dickey Hopkins Ungerleider | Student in an Organized Health Care Education/Training Program | 1520 San Pablo St, Suite 4300, Los Angeles, CA 90033-5310 | 2017-03-27 |
| 1740728344 | Michelle Kim | Surgery | 1520 San Pablo St, Hct 4300, Los Angeles, CA 90033-5310 | 2017-02-03 |
| 1144763095 | Demetrios Nectarios Mallios | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1520 San Pablo St, Health Consultation Ceneter II, Suite 4300, Los Angeles, CA 90033-5310 | 2016-11-27 |
| 1952843757 | Louis Zhang | Surgery | 1520 San Pablo St, Hct 4300, Los Angeles, CA 90033-5310 | 2016-11-09 |
| 1801246095 | Evan Alicuben | Surgery | 1520 San Pablo St, Hct 4300, Los Angeles, CA 90033-5310 | 2016-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376165050 | Noa Yee | Student in an Organized Health Care Education/Training Program | 1200 N. State Street, Gnh 1011, Los Angeles, CA 90033 | 2020-05-15 |
| 1629690144 | Monica Lopez | Respiratory Therapist, Registered | 1251 Marengo St, Los Angeles, CA 90033 | 2020-05-07 |
| 1649890401 | Antonio Hernandez Saenz | Student in an Organized Health Care Education/Training Program | 1200 N. State Street Gnh 1060k, Los Angeles, CA 90033 | 2020-04-22 |
| 1417585100 | Kelsey Grace Shea | Student in an Organized Health Care Education/Training Program | 1200 N State St Ird 112, Los Angeles, CA 90033 | 2020-03-30 |
| 1891322780 | Carolyn Kan | Student in an Organized Health Care Education/Training Program | 1200 North State Street Clinic Tower, Suite A7d, Los Angeles, CA 90033 | 2020-03-23 |
| 1902445786 | Maury M Hopkins | Registered Nurse | 1883 Marengo Street, Los Angeles, CA 90033 | 2019-12-27 |
| 1982259792 | Beverly Austin Mccabe | Registered Nurse | 1720 E. Cesar Chavez Ave., Los Angeles, CA 90033 | 2019-08-08 |
| 1093369399 | Christine Yoon | Pharmacist | 1611 E Cesar Chavez Ave, Los Angeles, CA 90033 | 2019-07-25 |
| 1073075339 | Johanna Keller | Student in an Organized Health Care Education/Training Program | La County +usc Medical Center, 2051 Marengo Street, Los Angeles, CA 90033 | 2019-04-04 |
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| Find all providers in zip 90033 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366084535 | Luo Xu | Radiology | 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 | 2019-10-09 |
| 1801138151 | Noah A Brauner | Radiology | 1200 N State Street, D&t 3d321, Los Angeles, CA 90033 | 2013-03-25 |
| 1346508827 | Frank Hao | Radiology | 11301 Wilshire Blvd # 114, Los Angeles, CA 90073-1003 | 2012-05-02 |
| 1578882965 | Pacific Vascucare, Inc. | Radiology | 1660 W 3rd St, Los Angeles, CA 90017-1138 | 2010-05-25 |
| 1841348711 | Ata Daniel Rezvanpour | Radiology | 6041 Cadillac Ave., Los Angeles, CA 90034-1702 | 2007-01-08 |
| 1730649120 | Elizabeth Herzog | Radiology | 4733 W Sunset Blvd Fl 3, Los Angeles, CA 90027-6021 | 2019-03-21 |
| 1902332471 | Peter Hu | Radiology | 1200 N. State Street, D&t 3d321, Los Angeles, CA 90033 | 2017-05-03 |
| 1982135315 | Shimwoo Lee | Radiology | 757 Westwood Plz Ste 1638, Los Angeles, CA 90095-2302 | 2017-03-27 |
| 1366981581 | Ali Golshan Md Inc | Radiology | 11633 San Vicente Blvd Ste 240, Los Angeles, CA 90049-6513 | 2017-02-21 |
| 1891140844 | Brian Boa-yen Ng | Radiology | 1200 N State St, Los Angeles, CA 90033-1029 | 2016-04-27 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.