Basic Information
| Provider Information | |||||||||
| NPI: | 1982750287 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PASI | ||||||||
| FirstName: | ASHEESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 625 FAIR OAKS AVE STE 270 | ||||||||
| Address2: | |||||||||
| City: | SOUTH PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910305801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263462455 | ||||||||
| FaxNumber: | 6266393005 | ||||||||
| Practice Location | |||||||||
| Address1: | 887 E 2ND ST | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917662009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094670797 | ||||||||
| FaxNumber: | 8777786944 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2007 | ||||||||
| LastUpdateDate: | 03/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A93810 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P01272657/DU4032 | 01 | CA | RAILROAD MEDICARE | OTHER | P01365658 | 01 | CA | RAILROAD MEDICARE-DU4034 | OTHER | APPROVED | 01 | CA | MEDI-CAL | OTHER |