Provider Demographics
NPI:1366527590
Name:SASSE, SCOTT A (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:SASSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2726 LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2619
Mailing Address - Country:US
Mailing Address - Phone:323-666-1252
Mailing Address - Fax:323-666-9474
Practice Address - Street 1:2000 STADIUM WAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026
Practice Address - Country:US
Practice Address - Phone:213-250-4200
Practice Address - Fax:323-666-9474
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2018-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG63480207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine