Provider Demographics
NPI: | 1477588176 |
---|---|
Name: | LITWER, CYNTHIA A (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | CYNTHIA |
Middle Name: | A |
Last Name: | LITWER |
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 240086 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90024-9186 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-445-2800 |
Mailing Address - Fax: | 310-445-2983 |
Practice Address - Street 1: | 1516 COTNER AVE |
Practice Address - Street 2: | |
Practice Address - City: | LOS ANGELES |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90025-3303 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-445-2800 |
Practice Address - Fax: | 310-445-2983 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-11 |
Last Update Date: | 2008-08-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G67587 | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 00G67587 | Other | BLUE SHIELD |
CA | 00G675870 | Medicaid | |
CA | 00G67587 | Other | BLUE SHIELD |
CA | F87237 | Medicare UPIN | |
CA | WG67587R | Medicare PIN | |
CA | WG67587S | Medicare PIN | |
CA | WG67587P | Medicare PIN |