Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | G21526 | CA |
NPI | 1245397215 |
---|---|
Provider Name | Dr. Gerald Bruce Whitman |
First Address | Beverly Hills, CA 90211-1789 |
Second Address | Beverly Hills, CA 90211-1789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |