Provider Demographics
NPI:1366713513
Name:ABBASI, SADEEA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SADEEA
Middle Name:
Last Name:ABBASI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:CT-A7D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1029
Mailing Address - Country:US
Mailing Address - Phone:323-226-7556
Mailing Address - Fax:323-226-2657
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:CT-A7D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-7556
Practice Address - Fax:323-226-2657
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113887390200000X
CAA123851207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA113887OtherSID # 113887