Healthcare Provider Details

I. General information

NPI: 1689752164
Provider Name (Legal Business Name): AKASH BAJAJ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13160 MINDANAO WAY STE 200
MARINA DEL REY CA
90292-7907
US

IV. Provider business mailing address

13157 MINDANAO WAY # 614
MARINA DEL REY CA
90292-6307
US

V. Phone/Fax

Practice location:
  • Phone: 310-482-6906
  • Fax:
Mailing address:
  • Phone: 310-482-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA83927
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA83927
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA83927
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA83927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: