Provider Demographics
NPI:1558572867
Name:SOMMERVILLE, BRITT JAMES (M D)
Entity Type:Individual
Prefix:
First Name:BRITT
Middle Name:JAMES
Last Name:SOMMERVILLE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-432-8900
Mailing Address - Fax:310-432-8968
Practice Address - Street 1:8900 WILSHIRE BLVD.
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-432-8900
Practice Address - Fax:310-432-8968
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0706132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA00014Medicaid
GA202I305245OtherMEDICARE
GA003137706SMedicaid