Provider Demographics
NPI:1538435565
Name:DARBAR-WOODLAND, NATASHA (PT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:DARBAR-WOODLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:DARBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:7949 SELMA AVE 17
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2686
Mailing Address - Country:US
Mailing Address - Phone:310-866-8620
Mailing Address - Fax:
Practice Address - Street 1:910 1/2 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1602
Practice Address - Country:US
Practice Address - Phone:310-657-7220
Practice Address - Fax:310-657-7221
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38845225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist