Healthcare Provider Details

I. General information

NPI: 1447598867
Provider Name (Legal Business Name): NATALIE BJELAJAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PLZ SUITE 565
LOS ANGELES CA
90095-0001
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-1489
  • Fax: 310-825-9170
Mailing address:
  • Phone: 310-301-8707
  • Fax: 310-825-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: