Provider Demographics
NPI:1295042232
Name:MICHAEL GITTER M.D., INC.
Entity Type:Organization
Organization Name:MICHAEL GITTER M.D., INC.
Other - Org Name:CENTRO MEDICO MACARTHUR PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-413-2700
Mailing Address - Street 1:2011 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3503
Mailing Address - Country:US
Mailing Address - Phone:213-413-2700
Mailing Address - Fax:213-484-1367
Practice Address - Street 1:2011 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3503
Practice Address - Country:US
Practice Address - Phone:213-413-2700
Practice Address - Fax:213-484-1367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL GITTER M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20658208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty