Provider Demographics
NPI:1740352632
Name:LUDMILA B. BESS, MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LUDMILA B. BESS, MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:E
Authorized Official - Last Name:BESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-934-8877
Mailing Address - Street 1:5901 W. OLYMPIC BOULEVARD.,
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036
Mailing Address - Country:US
Mailing Address - Phone:323-934-8877
Mailing Address - Fax:323-934-5008
Practice Address - Street 1:5901 W. OLYMPIC BOULEVARD.,
Practice Address - Street 2:SUITE 503
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036
Practice Address - Country:US
Practice Address - Phone:323-934-8877
Practice Address - Fax:323-934-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40563207V00000X
CAA50863207V00000X
CAA134652207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA134652OtherCALIFORNIA LICENSE
CAA134652OtherCALIFORNIA LICENSE
CAWA40563CMedicare UPIN
CAWA50863AMedicare UPIN