| Medical Office And Spa Of Dr Badalova Md | |
|
16260 Ventura Blvd Ste 315 Encino CA 91436-2234 | |
| (310) 954-9671 | |
| (310) 954-9046 |
| Full Name | Medical Office And Spa Of Dr Badalova Md |
|---|---|
| Speciality | General Practice |
| Location | 16260 Ventura Blvd Ste 315, Encino, California |
| Authorized Official Name and Position | Yelena Badalova (PRESIDENT) |
| Authorized Official Contact | 3109549671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Office And Spa Of Dr Badalova Md 16260 Ventura Blvd Ste 315 Encino CA 91436-2234 Ph: (310) 954-9671 | Medical Office And Spa Of Dr Badalova Md 16260 Ventura Blvd Ste 315 Encino CA 91436-2234 Ph: (310) 954-9671 |
| NPI Number | 1033757737 |
|---|---|
| Provider Enumeration Date | 12/13/2019 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 0143659581 |
|---|---|
| Medicare Enrollment ID | O20200406001112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033757737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Yelena Badalova |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750687497 PECOS PAC ID: 5496931800 Enrollment ID: I20110519000702 |
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