Provider Demographics
NPI:1841395001
Name:LITTLE, DAVID G (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HITCHING POST DR
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-5169
Mailing Address - Country:US
Mailing Address - Phone:310-283-4449
Mailing Address - Fax:818-230-9004
Practice Address - Street 1:7768 3/4 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6219
Practice Address - Country:US
Practice Address - Phone:310-283-4449
Practice Address - Fax:818-230-9004
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3767213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1760550735Medicaid
CA000E37670Medicaid
CAU18381Medicare UPIN
CAE3767Medicare ID - Type UnspecifiedMEDICARE NUMBER
CAE3767EMedicare ID - Type UnspecifiedMEDICARE NUMBER
CA000E37670Medicaid
CAE3767DMedicare ID - Type UnspecifiedMEDICARE NUMBER