Healthcare Provider Details

I. General information

NPI: 1265744783
Provider Name (Legal Business Name): THUSA SABAPATHY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 SUNSET BLVD., MS#76 , DIVISION OF GENERAL PEDIATRICS
LOS ANGELES CA
90027
US

IV. Provider business mailing address

4650 SUNSET BLVD., MS#76 , DIVISION OF GENERAL PEDIATRICS
LOS ANGELES CA
90027
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-6161
  • Fax:
Mailing address:
  • Phone: 323-361-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA125350
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberA125350
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number61005
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberA125350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: