Jack Ditlove, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

JACK DITLOVE, MD

Practice address

435 N Roxbury Dr Ste 102
Beverly Hills, CA 90210-5003

Phone

(310) 273-1150

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Pam Calderon

Title

Billing Manager

Phone

(310) 343-8884

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Ditlove, M.D.

  • Nephrology Physician
  • Beverly Hills, CA
  • NPI 1417961186
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356562730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR STE 102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105003",
            "telephone_number": "310-273-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR STE 102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105003",
            "telephone_number": "310-273-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK DITLOVE, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-343-8884"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Jablon, RMST
• Brian Paul Jacks, MD
• Jackson K Lau OD Inc
• Ashton Raiden Jackson, MD
• Greg Jackson, PPS
• Kirsten L Jackson

• Nephrology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.