Graham Gitlin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A63525 Issued in CA

Practice address

2080 Century Park E Ste 809
Los Angeles, CA 90067-2011

Phone

(310) 785-6614

Fax

(310) 785-6631

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1982688990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MARINE ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904056041",
            "telephone_number": "310-785-6614",
            "fax_number": "310-785-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 809",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672011",
            "telephone_number": "310-785-6614",
            "fax_number": "310-785-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITLIN",
        "first_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A63525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laudan Gish, LCSW
• Tiffany Gishizky, DNP, RN, PMHNP-BC
• Danielle Gissinger, PH.D.
• Gitae Kim Dental Group Inc
• Kullaya Gitbumrungsin
• Marcy H Gitlin, LCSW
• Michael Jay Gitlin, M.D.
• Rebecca Gitlin, PH.D.
• Steven Mark Gitlin, MD
• Barbara Gitlitz, M.D.

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.