Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Ditlove, MD

Individual provider Nephrology Physician · NPI 1417961186

Jack Ditlove, MD is a Nephrology in Beverly Hills, California. Qualified in 1972, 54 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
54
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

250 N Robertson Blvd Ste 501
Beverly Hills, CA 90211-1770
Phone: (310) 274-0200
Fax: (310) 274-0204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence G25418 (CA)

Record details

NPI number1417961186
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 28, 2006
Last updated in NPPESMarch 26, 2020
Certification dateMarch 26, 2020
Mailing address250 N Robertson Blvd Ste 501, Beverly Hills, CA 90211-1770

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1972 (54 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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