Individual
TRAVIS DESA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3650 SOUTH ST STE 310, LAKEWOOD, CA 90712-1519
(562) 531-1980
Mailing address
3650 SOUTH ST STE 310, LAKEWOOD, CA 90712-1519
(562) 531-1980
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
A183097
CA
207RI0011X
Interventional Cardiology Physician
T4907
TX
Other
Enumeration date
02/23/2015
Last updated
08/21/2025
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