Healthcare Provider Details

I. General information

NPI: 1104941616
Provider Name (Legal Business Name): VASEEMA SULTANA ARASTU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VASEEMA SULTANA KHAN

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/07/2023
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12675 LA MIRADA BLVD SUITE 200
LA MIRADA CA
90638
US

IV. Provider business mailing address

12675 LA MIRADA BLVD SUITE 200
LA MIRADA CA
90638
US

V. Phone/Fax

Practice location:
  • Phone: 562-941-9853
  • Fax: 562-941-9683
Mailing address:
  • Phone: 562-941-9853
  • Fax: 562-941-9683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA044428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: