Individual
FASHA F LILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 669-2534
(323) 663-6707
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(323) 669-2337
(323) 644-8488
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G60432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G604320
—
CA
Enumeration date
09/15/2006
Last updated
07/08/2007
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