Laura K Pietrzak, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA18203 Issued in CA

Practice address

4644 Lincoln Blvd Ste 552
Marina del Rey, CA 90292-6391

Phone

(310) 827-2653

NPI assigned

Feb 2, 2010

Last updated

Feb 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grant Stevens, M.D., Inc

  • Plastic Surgery Physician
  • Marina del Rey, CA
  • NPI 1639444714
  NPD (past)
• Marina Dermatology Associates

  dba Comprehensive Skin Care

  • Dermatology Physician
  • Marina del Rey, CA
  • NPI 1356778476
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1447582366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 YACHT CLUB WAY APT 237",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772066",
            "telephone_number": "310-962-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD STE 552",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926391",
            "telephone_number": "310-827-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRZAK",
        "first_name": "LAURA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Phan, PA-C
• Joseph Tri Phan, MD
• Xavier Lamance Phillips
• Physiotherapy Associates, Inc (Select Physical Therapy)
• Physiotherapy Associates, Inc.
• Leila Pope
• Michael Port, M.D.
• Prairie Medical Group
• Prostate Oncology Specialists, Inc.
• Nadezhda Protasovitskaya, NP

• Surgical Physician Assistant in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.