Provider Demographics
NPI:1306940846
Name:GITLIN, STEVEN MARK (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:GITLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9735 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #245
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2107
Mailing Address - Country:US
Mailing Address - Phone:310-276-5298
Mailing Address - Fax:310-276-5299
Practice Address - Street 1:2010 WILSHIRE BLVD
Practice Address - Street 2:SUITE #506
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3507
Practice Address - Country:US
Practice Address - Phone:213-413-5444
Practice Address - Fax:213-413-3577
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2010-01-14
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Provider Licenses
StateLicense IDTaxonomies
CA207RP1001X207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G287260Medicaid
CA00G287260Medicaid
CAW10494Medicare PIN