Provider Demographics
NPI:1598706350
Name:SASHI, CHINMAYI (PA)
Entity type:Individual
Prefix:
First Name:CHINMAYI
Middle Name:
Last Name:SASHI
Suffix:
Gender:
Credentials:PA
Other - Prefix:MRS
Other - First Name:CHINMAYI
Other - Middle Name:
Other - Last Name:SASHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:60 MDG- HLVC
Mailing Address - Street 2:101BODIN CIRCLE
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535-1800
Mailing Address - Country:US
Mailing Address - Phone:707-423-2300
Mailing Address - Fax:
Practice Address - Street 1:60 MDG- HLVC
Practice Address - Street 2:101BODIN CIRCLE
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535-1800
Practice Address - Country:US
Practice Address - Phone:707-423-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530542086S0102X
CAPA53054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty