Individual
JACK DITLOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 N ROBERTSON BLVD STE 501, BEVERLY HILLS, CA 90211-1770
(310) 274-0200
(310) 274-0204
Mailing address
250 N ROBERTSON BLVD STE 501, BEVERLY HILLS, CA 90211-1770
(310) 274-0200
(310) 274-0204
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G25418
CA
Other
Enumeration date
07/28/2006
Last updated
03/26/2020
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