# MEDICAL OFFICE AND SPA OF DR BADALOVA MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033757737
- **Authorized official:** YELENA BADALOVA MD (PRESIDENT)
- **Authorized official phone:** (310) 954-9671

## Contact information

- **Practice address:** 16260 VENTURA BLVD STE 315, ENCINO, CA 91436-2234
- **Practice address phone:** (310) 954-9671
- **Practice address fax:** (310) 954-9046
- **Mailing address:** 16260 VENTURA BLVD STE 315, ENCINO, CA 91436-2234
- **Mailing address phone:** (310) 954-9671
- **Mailing address fax:** (310) 954-9046

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2019
- **Last updated:** 12/13/2019