Healthcare Provider Details

I. General information

NPI: 1487373494
Provider Name (Legal Business Name): NATALIA BARAJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6826 S CENTINELA AVE
CULVER CITY CA
90230-6301
US

IV. Provider business mailing address

13503 CLOSE ST
WHITTIER CA
90605-3305
US

V. Phone/Fax

Practice location:
  • Phone: 310-915-6100
  • Fax:
Mailing address:
  • Phone: 562-619-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number302519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: