Provider Demographics
NPI:1508912247
Name:PITTS, MARTIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:A
Last Name:PITTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 LOMITA BLVD STE 442
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4882
Mailing Address - Country:US
Mailing Address - Phone:917-538-0776
Mailing Address - Fax:310-530-3070
Practice Address - Street 1:3440 LOMITA BLVD STE 442
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4882
Practice Address - Country:US
Practice Address - Phone:917-538-0776
Practice Address - Fax:310-530-3070
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034399207P00000X
CAC128708207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD758599 02OtherBLUE SHIELD
DEJ879 0001OtherBLUE SHIELD
DCP00129709OtherRAILROAD MED
MD403369800Medicaid
DC035407800Medicaid
DEJ879 0001OtherBLUE SHIELD
DC013559M32Medicare PIN