Provider Demographics
NPI:1760261747
Name:MELLITUS HEALTH INC
Entity Type:Organization
Organization Name:MELLITUS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PRODUCT OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-218-0805
Mailing Address - Street 1:269 S BEVERLY DR # 613
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3851
Mailing Address - Country:US
Mailing Address - Phone:424-218-0805
Mailing Address - Fax:
Practice Address - Street 1:9538 W PICO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1256
Practice Address - Country:US
Practice Address - Phone:424-218-0805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty