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General NPI Number Information
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NPI Number | 1285034199
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Entity Type | Organization
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Legal Business Name | VARINTHREJ PITIS MD INC
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 312-925-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 3435 OCEAN PARK BLVD #107, PMB 679
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City | SANTA MONICA
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State | CA
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Zip | 90405-3301
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Country | US
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Telephone | 312-925-3183
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. VARINTHREJ PITIS
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Credential | M.D.
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Telephone | 312-925-3183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A122811
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A122811
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License Number State | CA
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