MEDICARE: VICTOR NITTI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	G70937	CA
2	208800000X	Urology Physician	G70937	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003800806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR NITTI M.D.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 UCLA MEDICAL PLZ STE 140
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-8344
Country	:	US
Telephone Number	:	310-794-7700
Fax Number	:	310-794-0211

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	11/17/2020

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Directions to “ VICTOR NITTI M.D.” Practice Location

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