Healthcare Provider Details

I. General information

NPI: 1386716322
Provider Name (Legal Business Name): MELVIN HARVEY NUTIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD STE 360
BEVERLY HILLS CA
90211-2173
US

IV. Provider business mailing address

150 N ROBERTSON BLVD STE 250
BEVERLY HILLS CA
90211-2145
US

V. Phone/Fax

Practice location:
  • Phone: 310-659-2910
  • Fax: 310-652-2568
Mailing address:
  • Phone: 310-659-2910
  • Fax: 310-652-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA29399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: