Healthcare Provider Details

I. General information

NPI: 1740486323
Provider Name (Legal Business Name): AARTI KAUSHIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 SAN PABLO ST 350
LOS ANGELES CA
90033-5320
US

IV. Provider business mailing address

1815 MERIDIAN AVE 307
SOUTH PASADENA CA
91030-4356
US

V. Phone/Fax

Practice location:
  • Phone: 310-442-5940
  • Fax:
Mailing address:
  • Phone: 310-408-8643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberA108892
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2007017272.
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: