Provider Demographics
NPI:1104941616
Name:ARASTU, VASEEMA SULTANA (MD)
Entity type:Individual
Prefix:DR
First Name:VASEEMA
Middle Name:SULTANA
Last Name:ARASTU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VASEEMA
Other - Middle Name:SULTANA
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12675 LA MIRADA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:562-941-9853
Mailing Address - Fax:562-941-9683
Practice Address - Street 1:12675 LA MIRADA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638
Practice Address - Country:US
Practice Address - Phone:562-941-9853
Practice Address - Fax:562-941-9683
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA044428208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
152268OtherAPP ID
CA00A444280Medicaid
CA00A444280Medicaid
152268OtherAPP ID
CAFA796ZMedicare PIN