Provider Demographics
NPI:1801097118
Name:BITTAR, NATALI K (MD)
Entity type:Individual
Prefix:DR
First Name:NATALI
Middle Name:K
Last Name:BITTAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:BITTAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4085 GOVERNOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2522
Mailing Address - Country:US
Mailing Address - Phone:858-888-7800
Mailing Address - Fax:858-888-7801
Practice Address - Street 1:4085 GOVERNOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2522
Practice Address - Country:US
Practice Address - Phone:858-888-7800
Practice Address - Fax:858-888-7801
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A100100Medicaid
CAWA100100AMedicare PIN