NPIMap

Individual provider Active NPI

Daniel Vitantonio, MD

  • Clinical Neurophysiology Physician
  • Marina del Rey, CA
National Provider Identifier
1083024145
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
A143344 Issued in CA
Practice address
475 Washington Blvd
Marina del Rey, CA 90292-5287
Phone
(310) 923-1437
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 20835 NH
Neurology Physician 2084N0400X A143344 CA
Neurology Physician 2084N0400X 4301502449 MI
Clinical Neurophysiology Physician 2084N0600X A143344 CA Primary
Neurology Physician 2084N0400X T1593 TX

Addresses

Primary practice location

475 Washington Blvd
Marina del Rey, CA 90292-5287

Mailing address

PO Box 2277
Venice, CA 90294-2277
Phone (310) 923-1437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190807003131 CA Practitioner - Neurology 5698002079 Reassigns benefits to 1 organization
I20240116000621 TX Practitioner - Neurology 5698002079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gamma Neuro Network IncGroup PAC ID 5294187290, 5 clinicians

Practice addresses (Care Compare)

2828 Canto Trce
Leander, TX 78641-5568
Phone (310) 923-1437

475 Washington Blvd
Marina del Rey, CA 90292-5287
Phone (310) 923-1437

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
303962NYMDLicensed Practical Nurse
A143344CAMDNeurology Physician
4301502449MIMDNeurology Physician
20835NHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gamma Neuro Network of Texas PLLC Clinical Neurophysiology Current Accepting new patients
Amb Eeg LLC CurrentSince Mar 1, 2023 Accepting new patients
Gamma Neuro Diagnostics Inc Clinical Neurophysiology Current Accepting new patients
Gamma Neuro Network Inc Clinical Neurophysiology CurrentSince Nov 8, 2023 Accepting new patients
Neuralview Medical Group PC PastSince Dec 1, 2015 Accepting new patients
Rtna PC Past Accepting new patients

Locations

475 Washington Blvd
Marina del Rey, CA 90292
Phone (310) 571-8156

20331 Irvine Ave
Ste E2
Newport Beach, CA 92660
Phone (619) 200-4140

Interoperability endpoints

  • Direct secure messaging: dvitantonio368481@direct.ahsys.org
  • Direct secure messaging: dvitantonio720987@direct.hfhs.org
  • Direct secure messaging: dvitantonio690362@hisp.ehr.sutterhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1083024145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2277",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902942277",
            "telephone_number": "310-923-1437",
            "fax_number": "310-439-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WASHINGTON BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925287",
            "telephone_number": "310-923-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITANTONIO",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "20835",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A143344",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301502449",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A143344",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "T1593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.