Vaseema Sultana Arastu, MD

Individual provider Active NPI Pediatrics Physician · La Mirada, CA

NPI 1104941616 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1104941616
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
A044428 (CA)
Practice address
12675 La Mirada Blvd
Suite 200
La Mirada, CA 90638
Phone
(562) 941-9853
Fax
(562) 941-9683
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110621000296 CA Practitioner - Pediatric Medicine 9638357783 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A044428CAMDPediatrics Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Anwar & Vaseema Arastu, MD, Inc Current Accepting new patients
Anwar and Vaseema Arastu M D Inc Pediatrics Current
since Apr 26, 2011
Accepting new patients
Healthylife MG Corp Past Accepting new patients

Locations

12675 La Mirada Blvd
Ste 200
La Mirada, CA 90638
Phone (562) 941-9853

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A044428 CA Yes

Addresses

Primary practice location

12675 La Mirada Blvd
Suite 200
La Mirada, CA 90638

Mailing address

12675 La Mirada Blvd
Suite 200
La Mirada, CA 90638
Phone (562) 941-9853

Other identifiers

IdentifierTypeStateIssuer
152268OtherAPP ID
00A444280MedicaidCA

Other names

  • Vaseema Sultana Khan Former name

Other providers in La Mirada, CA

All providers in La Mirada, CA · Pediatrics Physician in California

Sources for this page

Verify at the official NPI Registry.