Basic Information
Provider Information
NPI: 1184041147
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JASUJA
FirstName: SONIA
MiddleName:  
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Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3108258061
FaxNumber:  
Practice Location
Address1: 200 UCLA MEDICAL PLZ STE 365B
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900958344
CountryCode: US
TelephoneNumber: 3108257921
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2014
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA140210CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001XA140210CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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