Provider Demographics
NPI:1689696775
Name:TILLOU, ARETI (MD)
Entity Type:Individual
Prefix:
First Name:ARETI
Middle Name:
Last Name:TILLOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 214
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-794-7788
Practice Address - Fax:310-794-3344
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA73911208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A739110Medicaid
CA00A739110Medicaid
CAWA73911BMedicare PIN