Provider Demographics
NPI:1780633537
Name:BESS, LUDMILA B (MD)
Entity Type:Individual
Prefix:
First Name:LUDMILA
Middle Name:B
Last Name:BESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUDMILA
Other - Middle Name:
Other - Last Name:BEZFAMILNAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5901 W OLYMPIC BLVD
Mailing Address - Street 2:STE 503
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4667
Mailing Address - Country:US
Mailing Address - Phone:323-934-8877
Mailing Address - Fax:323-934-5008
Practice Address - Street 1:5901 W OLYMPIC BLVD
Practice Address - Street 2:STE 503
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4667
Practice Address - Country:US
Practice Address - Phone:323-934-8877
Practice Address - Fax:323-934-5008
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40563207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A405630Medicaid
CAW12297Medicare ID - Type UnspecifiedGROUP NUMBER
CA00A405630Medicaid
CAWA40563CMedicare ID - Type UnspecifiedPPIN