Provider Demographics
NPI:1144497561
Name:NATCHEVA, PAVLINA STEFANOVA (MD)
Entity type:Individual
Prefix:DR
First Name:PAVLINA
Middle Name:STEFANOVA
Last Name:NATCHEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAVLINA
Other - Middle Name:STEFANOVA
Other - Last Name:NATCHEVA-SMITAMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3282 CAMINITO EASTBLUFF UNIT 109
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4540 VANDEVER AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-3567
Practice Address - Country:US
Practice Address - Phone:619-590-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049768207Q00000X
CAA120290207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine