Organization
JACK DITLOVE, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM CALDERON (BILLING MANAGER)
(310) 343-8884
Entity
Organization
Contact information
Practice address
435 N ROXBURY DR STE 102, BEVERLY HILLS, CA 90210-5003
(310) 273-1150
Mailing address
435 N ROXBURY DR STE 102, BEVERLY HILLS, CA 90210-5003
(310) 273-1150
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
CA
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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