Healthcare Provider Details

I. General information

NPI: 1497742902
Provider Name (Legal Business Name): NATALIE Z. CVIJANOVICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

7275 WILD CURRANT WAY
OAKLAND CA
94611-1340
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA76109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: