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NPI Code Detail

MEDICARE: DR. MARVIN BENJAMIN PITTMAN DDS

MEDICARE:  DR. MARVIN BENJAMIN PITTMAN  DDS
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
1122300000XDentist19953CA

General Provider Information

NPI Number : 1568511681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARVIN BENJAMIN PITTMAN DDS
Provider Business Mailing Address
First Line : 1818 S WESTERN AVE
Second Line : SUITE 402
City : LOS ANGELES
State : CA
Zip : 90006-5860
Country : US
Telephone Number : 323-731-8586
Fax Number : 323-731-2721
Provider Business Practice Location Address
First Line : 1818 S WESTERN AVE
Second Line : SUITE 402
City : LOS ANGELES
State : CA
Zip : 90006-5860
Country : US
Telephone Number : 323-731-8586
Fax Number : 323-731-2721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MARVIN BENJAMIN PITTMAN DDS” Practice Location

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