| Doctor Name: | YELENA BADALOVA |
| NPI Number: | 1750687497 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | A115507 |
| Business Practice Address: | 2222 Santa Monica Blvd Suite 205 Santa Monica, CA - 904042304 |
| Business Phone Number: | 3104491007 |
| Business Fax Number: | 3104490081 |
| Mailing Address: | 908 11th St Apt 4, SANTA MONICA |
| State: | CA |
| Postal Code: | 904032939 |
| Phone Number: | 3237176282 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2011 |
| NPI Last Update Date: | 04/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A115507 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |