Provider Demographics
NPI:1881024305
Name:NAT-VASILJ, MANITA KAUR (MD)
Entity type:Individual
Prefix:
First Name:MANITA
Middle Name:KAUR
Last Name:NAT-VASILJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 HECKMANN LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3356
Mailing Address - Country:US
Mailing Address - Phone:818-303-5721
Mailing Address - Fax:
Practice Address - Street 1:1035 HECKMANN LN
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3356
Practice Address - Country:US
Practice Address - Phone:818-303-5721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158994207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology