Healthcare Provider Details

I. General information

NPI: 1194391813
Provider Name (Legal Business Name): NATALIE WEBER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26672 PORTOLA PKWY STE 104
FOOTHILL RANCH CA
92610-1773
US

IV. Provider business mailing address

2231 N HIGH ST
COLUMBUS OH
43201-1101
US

V. Phone/Fax

Practice location:
  • Phone: 949-557-0750
  • Fax:
Mailing address:
  • Phone: 614-293-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: