Healthcare Provider Details

I. General information

NPI: 1902434939
Provider Name (Legal Business Name): SASHA HUBSCHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S SUNSET AVE STE 210
WEST COVINA CA
91790-3938
US

IV. Provider business mailing address

1135 S SUNSET AVE STE 210
WEST COVINA CA
91790-3938
US

V. Phone/Fax

Practice location:
  • Phone: 626-653-9395
  • Fax:
Mailing address:
  • Phone: 626-653-9395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number036167953
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036167953
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: