Healthcare Provider Details

I. General information

NPI: 1710306592
Provider Name (Legal Business Name): ONITA BHATTASALI M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W SUNSET BLVD SECOND FLOOR
LOS ANGELES CA
90027-5822
US

IV. Provider business mailing address

4950 W SUNSET BLVD FL 2
LOS ANGELES CA
90027-5822
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-2841
  • Fax: 323-783-5927
Mailing address:
  • Phone: 323-783-2841
  • Fax: 323-783-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD70136099
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA139820
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10049441
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: