Organization
NATALIE BLANCO MIRSKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIE BLANCO MIRSKY (FOUNDER MANAGING DIRECTOR)
(310) 270-7549
Entity
Organization
Contact information
Practice address
1831 WILSHIRE BLVD STE E, SANTA MONICA, CA 90403-5779
(310) 453-1221
(310) 829-5319
Mailing address
1831 WILSHIRE BLVD STE E, SANTA MONICA, CA 90403-5779
(310) 453-1221
(310) 829-5319
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7458842
AETNA
CA
Enumeration date
03/09/2007
Last updated
06/27/2008
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