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Individual

MATTHEW J LOTYSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
555 E HARDY ST, INGLEWOOD, CA 90301-4011
(310) 673-4660
Mailing address
PO BOX 5686, ORANGE, CA 92863-5686
(888) 598-8819
(714) 571-5055

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
G39962
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G399620
BLUE SHIELD OF CA
05
00G399620
CA
01
00G399620E02
CALOPTIMA
01
P00407406
RAILROAD MEDICARE
Enumeration date
01/24/2007
Last updated
08/15/2008
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