Provider Demographics
NPI:1922050392
Name:WRIGHT, NATASHA (PA)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3505 CADILLAC AVE STE N2
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1433
Mailing Address - Country:US
Mailing Address - Phone:714-979-5680
Mailing Address - Fax:714-668-9341
Practice Address - Street 1:1331 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5410
Practice Address - Country:US
Practice Address - Phone:310-566-1367
Practice Address - Fax:310-566-1300
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA 14048363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical