Healthcare Provider Details

I. General information

NPI: 1326102112
Provider Name (Legal Business Name): HARVEY LUDOVIC DEUTSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 SANTA MONICA BLVD STE 320E
SANTA MONICA CA
90404-2150
US

IV. Provider business mailing address

2021 SANTA MONICA BLVD STE 320E
SANTA MONICA CA
90404-2150
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-3404
  • Fax: 310-829-2266
Mailing address:
  • Phone: 310-829-3404
  • Fax: 310-829-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG46608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: