Provider Demographics
NPI:1174782833
Name:ROMAN A. LITWINSKI, M.D., INC
Entity type:Organization
Organization Name:ROMAN A. LITWINSKI, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARI
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-673-6950
Mailing Address - Street 1:575 E HARDY ST
Mailing Address - Street 2:SUITE 322
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4053
Mailing Address - Country:US
Mailing Address - Phone:310-673-6950
Mailing Address - Fax:310-671-9989
Practice Address - Street 1:575 E HARDY ST
Practice Address - Street 2:SUITE 322
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4053
Practice Address - Country:US
Practice Address - Phone:310-673-6950
Practice Address - Fax:310-671-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA876342086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87634Medicare UPIN