MEDICARE: MS. NATALIE RACHEL BENUDIZ MPAP, PA-C

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	363A00000X	Physician Assistant	PA18482	CA

General Provider Information

NPI Number	:	1932542099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATALIE RACHEL BENUDIZ MPAP, PA-C

Provider Business Mailing Address
First Line	:	11122 CASHMERE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-3203
Country	:	US
Telephone Number	:	310-472-5973
Fax Number	:

Provider Business Practice Location Address
First Line	:	2324 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4002
Country	:	US
Telephone Number	:	213-383-3600
Fax Number	:

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

Provider Enumeration Date	:	04/09/2013
Last Update Date	:	04/09/2013

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