Individual
DR. JEROME PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
8635 W 3RD STREET, STE 1180 W, LOS ANGELES, CA 90048
(323) 633-5830
Mailing address
6709, LA TIJERA BLVD, STE# 923, LOS ANGELES, CA 90045
(323) 633-5830
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G47112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G47112
STATE LICENSE
CA
Enumeration date
10/04/2006
Last updated
07/08/2007
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