# CHARLES B. WITT, JR MD INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHARLES B. WITT, JR MD INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447576145
- **Legal business name:** CHARLES B. WITT, JR MD INC
- **Authorized official:** DR. CHARLES BENJAMIN WITT JR. M.D. (PRESIDENT)
- **Authorized official phone:** (323) 466-7333

## Contact information

- **Practice address:** 316 NORTH ROSSMORE AVENUE, SUITE 507, LOS ANGELES, CA 90004-2415
- **Practice address phone:** (323) 466-7333
- **Practice address fax:** (323) 871-1696
- **Mailing address:** 316 NORTH ROSSMORE AVENUE, SUITE 507, LOS ANGELES, CA 90004-2415
- **Mailing address phone:** (323) 466-7333
- **Mailing address fax:** (323) 871-1696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | G3366 | CA | — |
| 208D00000X | General Practice Physician | G3366 | CA | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | G3366 | CA | — |

## Other

- **Enumeration date:** 04/20/2010
- **Last updated:** 04/20/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000G33660 | — | CA |