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

Jon A Detterich, MD

Individual provider Pediatric Emergency Medicine (Emergency Medicine) Physician · NPI 1659518884

Jon A Detterich, MD is a Cardiovascular Disease (Cardiology) in Los Angeles, California. Graduated from Medical College of Wisconsin in 2003, 23 years ago. Practices with Childrens Hospital Los Angeles Medical Group Inc, a 288-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
23
Trained at
Medical College of Wisconsin
Licensed in
CA
In the registry since
2009
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

4650 W Sunset Blvd MS #113
Los Angeles, CA 90027-6062
Phone: (323) 361-2109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Emergency Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PP0204X · Licence A89834 (CA)

Record details

NPI number1659518884
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 9, 2009
Last updated in NPPESJanuary 9, 2009

Medicare enrollment

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

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2003 (23 years in practice)
Group practice Childrens Hospital Los Angeles Medical Group Inc — 288 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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