Basic Information
Provider Information
NPI: 1205859055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOLITZ
FirstName: HOWARD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7001
Address2:  
City: TARZANA
State: CA
PostalCode: 913577001
CountryCode: US
TelephoneNumber: 8188887815
FaxNumber: 8187151722
Practice Location
Address1: 2080 CENTURY PARK E
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900672001
CountryCode: US
TelephoneNumber: 3102771846
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 03/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XC31619CCAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900XC31619CCAN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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