Charles B. Witt, Jr MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G3366 Issued in CA

Legal business name

CHARLES B. WITT, JR MD INC

Practice address

316 North Rossmore Avenue
Suite 507
Los Angeles, CA 90004-2415

Phone

(323) 466-7333

Fax

(323) 871-1696

NPI assigned

Apr 20, 2010

Organization subpart

Yes

Parent organization

CHARLES B. WITT, JR MD INCAs reported in NPPES

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

Authorized official

Name

Dr. Charles Benjamin Witt Jr., M.D.

Title

President

Phone

(323) 466-7333

Specialties & licenses 3

Addresses

Other identifiers 1

Part of

Charles B Witt Jr MD Inc

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1447576145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 NORTH ROSSMORE AVENUE",
            "address_2": "SUITE 507",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042415",
            "telephone_number": "323-466-7333",
            "fax_number": "323-871-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 NORTH ROSSMORE AVENUE",
            "address_2": "SUITE 507",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042415",
            "telephone_number": "323-466-7333",
            "fax_number": "323-871-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES B. WITT, JR MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLES B. WITT, JR MD INC",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "WITT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-466-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G3366",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G3366",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G3366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000G33660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.