IndividualActive
Jon Detterich, MD
NPI 1659518884 · Pediatric Emergency Medicine (Emergency Medicine) Physician · Los Angeles, CA
Provider details
- NPI number
- 1659518884
- Entity type
- Individual
- Primary specialty
- Pediatric Emergency Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- A89834 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4650 W Sunset Blvd
Ms #113
Los Angeles, CA 90027-6062
Phone: (323) 361-2109
Approximate (ZIP-level) locationGet directions
Mailing address
6430 W Sunset Blvd
Los Angeles, CA 90028-7901
Registry dates
- Enumerated
- 2009-01-09
- Last updated
- 2009-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.