MEDICARE: MICHAEL A AUSTERLITZ MD, INC

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	207RN0300X	Nephrology Physician	A25290	CA

General Provider Information

NPI Number	:	1538345160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A AUSTERLITZ MD, INC

Provider Business Mailing Address
First Line	:	4588 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2430
Country	:	US
Telephone Number	:	323-265-2917
Fax Number	:

Provider Business Practice Location Address
First Line	:	4588 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2430
Country	:	US
Telephone Number	:	323-265-2917
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL AUGUST AUSTERLITZ
Credential	:	MD
Telephone Number	:	323-265-2917

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	03/31/2015

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