Individual provider Active NPI

Sasha Ebrahimi, MD PHD

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1174273072
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
200 UCLA Medical PLZ Ste B265
Los Angeles, CA 90095-4015
Phone
(310) 267-5575
NPI assigned
Mar 24, 2022
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste B265
Los Angeles, CA 90095-4015

Mailing address

200 UCLA Medical PLZ Ste B265
Los Angeles, CA 90095-8344
Phone (310) 267-5575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922002959 CA Order and Referring Only - Radiation OncologyPractitioner - Radiation Oncology 2264886373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1174273072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE B265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-267-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE B265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900954015",
            "telephone_number": "310-267-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMI",
        "first_name": "SASHA",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.