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General NPI Number Information
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NPI Number | 1063543627
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Entity Type | Organization
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Legal Business Name | WITMER NEONATOLOGY ASSOCIATES,INC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-977-4123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9690
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City | GLENDALE
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State | CA
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Zip | 91226-0690
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Country | US
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Telephone | 818-897-0201
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Fax | 818-897-0176
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. BIJAN SIASSI
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Credential | M.D.
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Telephone | 323-226-3499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | FNP 29985
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License Number State | CA
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