MEDICARE: NATALIA DE ROJAS RDHAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	HAP210	CA

General Provider Information

NPI Number	:	1831418326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA DE ROJAS RDHAP

Provider Business Mailing Address
First Line	:	21143 HAWTHORNE BLVD
Second Line	:	336A
City	:	TORRANCE
State	:	CA
Zip	:	90503-4615
Country	:	US
Telephone Number	:	424-206-1793
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 GRAHAM AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-2120
Country	:	US
Telephone Number	:	424-206-1793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2010
Last Update Date	:	05/23/2010

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