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General NPI Number Information
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NPI Number | 1750676219
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Entity Type | Organization
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Legal Business Name | LUIS C. NATALI MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD SUITE 509
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 914-393-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 6221 WILSHIRE BLVD SUITE 509
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 914-393-9660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS CARLOS NATALI
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Credential | M.D.
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Telephone | 914-393-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 236835
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD441094
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | A115959
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A115959
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License Number State | CA
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