Healthcare Provider Details
I. General information
NPI: 1972470730
Provider Name (Legal Business Name): DIGESTIVE HEALTH ASSOCIATES OF SOUTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 20TH ST STE 280
SANTA MONICA CA
90404-2053
US
IV. Provider business mailing address
1301 20TH ST STE 280
SANTA MONICA CA
90404-2053
US
V. Phone/Fax
- Phone: 310-829-6789
- Fax: 310-935-3163
- Phone: 310-829-6789
- Fax: 310-935-3163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAHUL
DIXIT
Title or Position: PARTNER
Credential:
Phone: 727-410-1571