Provider Demographics
NPI:1679109680
Name:NATSIS, NICOLA EVA (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLA
Middle Name:EVA
Last Name:NATSIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 WILSHIRE BLVD STE 545
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2009
Mailing Address - Country:US
Mailing Address - Phone:310-854-3003
Mailing Address - Fax:
Practice Address - Street 1:8920 WILSHIRE BLVD STE 545
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2009
Practice Address - Country:US
Practice Address - Phone:310-854-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA177028207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology