Provider Demographics
NPI:1952321044
Name:WHITEMAN, ELIZABETH JANE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 WILSHIRE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3151
Mailing Address - Country:US
Mailing Address - Phone:310-385-3511
Mailing Address - Fax:310-284-8611
Practice Address - Street 1:8501 WILSHIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3151
Practice Address - Country:US
Practice Address - Phone:310-385-3511
Practice Address - Fax:310-284-8611
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65539207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A655390Medicaid
CA00A655390Medicaid
CAWA65539BMedicare PIN