Provider Demographics
NPI:1932396819
Name:BASU, AASHNA RAJAN (MD)
Entity type:Individual
Prefix:DR
First Name:AASHNA
Middle Name:RAJAN
Last Name:BASU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RAJAN
Other - Middle Name:
Other - Last Name:SOHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6220 BRISTOL PKWY
Mailing Address - Street 2:APT 117
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6940
Mailing Address - Country:US
Mailing Address - Phone:213-339-1178
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION SERVICE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:213-399-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98898208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation