MEDICARE: DR. DUSAN SAJIC M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	C204913	CA

General Provider Information

NPI Number	:	1043166648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUSAN SAJIC M.D.

Provider Business Mailing Address
First Line	:	11645 WILSHIRE BLVD
Second Line	:	#800
City	:	LOS ANGELES
State	:	CA
Zip	:	90025
Country	:	US
Telephone Number	:	647-964-4655
Fax Number	:

Provider Business Practice Location Address
First Line	:	11645 WILSHIRE BLVD
Second Line	:	#800
City	:	LOS ANGELES
State	:	CA
Zip	:	90025
Country	:	US
Telephone Number	:	310-443-5273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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