Individual
REBECCA LOUIS FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
321 N LARCHMONT BLVD, SUITE 906, LOS ANGELES, CA 90004-3025
(323) 464-8046
(323) 464-1832
Mailing address
PO BOX 2866, TORRANCE, CA 90509-2866
(310) 792-0601
(310) 792-9062
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A49000
CA
207NS0135X
Procedural Dermatology Physician
Primary
A49000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A490000
BLUE SHIELD
CA
Enumeration date
04/26/2006
Last updated
09/11/2025
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