Provider Demographics
NPI:1386716322
Name:NUTIG, MELVIN HARVEY (MD)
Entity type:Individual
Prefix:
First Name:MELVIN
Middle Name:HARVEY
Last Name:NUTIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N ROBERTSON BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2145
Mailing Address - Country:US
Mailing Address - Phone:310-659-2910
Mailing Address - Fax:310-652-2568
Practice Address - Street 1:150 N ROBERTSON BLVD STE 360
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2173
Practice Address - Country:US
Practice Address - Phone:310-659-2910
Practice Address - Fax:310-652-2568
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29399207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25743Medicare UPIN
CAWA29399CMedicare PIN
CA0827950001Medicare NSC