Healthcare Provider Details

I. General information

NPI: 1366145575
Provider Name (Legal Business Name): DAVID JOSEPH HUTTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD
WEST HOLLYWOOD CA
90048-3311
US

IV. Provider business mailing address

127 S SAN VICENTE BLVD PAVILION BUILDING, SUITE A3100
WEST HOLLYWOOD CA
90048-3311
US

V. Phone/Fax

Practice location:
  • Phone: 310-204-2327
  • Fax: 310-204-2327
Mailing address:
  • Phone: 310-204-2327
  • Fax: 310-204-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: