Provider Demographics
NPI:1467488015
Name:GITLITZ, BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:GITLITZ
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-865-3105
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:NOR 8302E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0112
Practice Address - Country:US
Practice Address - Phone:323-865-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70326207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50018ZOtherGROUP BLUE SHIELD
CACE1617OtherGROUP RAILROAD MEDICARE
CAGR0100430OtherGROUP MEDICAL
CA1356390009OtherGROUP NPI
CA06E2774OtherGROUP CHAMPUS
CA00G703260197OtherCAL OPTIMA
CA00G703260Medicaid
CA1902846306OtherGROUP NPI
CAGR0016910OtherGROUP MEDICAID PIN
CA00G703260OtherBLUE SHIELD
CAP00339107OtherRAILROAD MEDICARE
CAW11675OtherGROUP MEDICARE PIN
CAW18762OtherGROUP MEDICARE
CA00G703260OtherBLUE SHIELD
CA1902846306OtherGROUP NPI