Provider Demographics
NPI:1154425379
Name:WITTLIN, BYRON JAY (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:JAY
Last Name:WITTLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:#116H
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-551-7350
Mailing Address - Fax:415-861-2008
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:#116H
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-551-7350
Practice Address - Fax:415-861-2008
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG252672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry