Healthcare Provider Details

I. General information

NPI: 1205008265
Provider Name (Legal Business Name): ANDREW I SPITZER, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 S SAN VICENTE BLVD #603
LOS ANGELES CA
90048-4165
US

IV. Provider business mailing address

PO BOX 7127
BEVERLY HILLS CA
90212-7127
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-9211
  • Fax:
Mailing address:
  • Phone: 310-423-9211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG74228
License Number StateCA

VIII. Authorized Official

Name: DR. ANDREW I SPITZER
Title or Position: OWNER
Credential: MD
Phone: 310-423-9211