Provider Demographics
NPI:1285613943
Name:HARWITT, MARC H (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:H
Last Name:HARWITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 20TH ST 376
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2087
Mailing Address - Country:US
Mailing Address - Phone:310-829-6789
Mailing Address - Fax:310-935-3163
Practice Address - Street 1:1301 20TH ST STE 280
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2053
Practice Address - Country:US
Practice Address - Phone:310-829-6789
Practice Address - Fax:310-935-3163
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23138207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G231380Medicaid
CAWG23138BMedicare ID - Type Unspecified
CA00G231380Medicaid