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General NPI Number Information
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NPI Number | 1689816225
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Entity Type | Organization
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Legal Business Name | WILLIAM E HITSELBERGER M D INC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 2222 OCEAN VIEW AVE SUITE 119
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City | LOS ANGELES
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State | CA
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Zip | 90057-2757
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Country | US
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Telephone | 213-387-5651
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Fax | 213-387-0019
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Provider Business Mailing Address
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Address Line | 2222 OCEAN VIEW AVE SUITE 119
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City | LOS ANGELES
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State | CA
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Zip | 90057-2757
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Country | US
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Telephone | 213-387-5651
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Fax | 213-387-0019
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM E HITSELBERGER
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Credential | MD
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Telephone | 213-387-5651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | C25264
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License Number State | CA
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