Healthcare Provider Details

I. General information

NPI: 1811375371
Provider Name (Legal Business Name): ADITYA ASHVINBHAI KOTECHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date: 12/28/2015
Reactivation Date: 01/08/2016

III. Provider practice location address

3701 SKYPARK DR STE 200
TORRANCE CA
90505-4749
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-378-8900
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number42811
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: