MEDICARE: JAY D. PRUETZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A81000	CA
2	2080P0202X	Pediatric Cardiology Physician	A81000	CA

General Provider Information

NPI Number	:	1790771053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY D. PRUETZ M.D.

Provider Business Mailing Address
First Line	:	4140 W 190TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-5513
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 S SAN VICENTE BLVD STE A3600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-3311
Country	:	US
Telephone Number	:	310-423-1153
Fax Number	:	310-423-6795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	04/14/2026

Similar Medicare Providers

1922875947 — CYNTHIA HUGHES NP-C
Practice Location Address:

127 S SAN VICENTE BLVD FL 7
LOS ANGELES, CA
90048-3311

Practice Phone: 310-423-1160
Practice Fax: 310-423-4646

1578407904 — DR. BARLIZ WAISSENGRIN MD
Practice Location Address:

127 S SAN VICENTE BLVD FL 7
LOS ANGELES, CA
90048-3311

Practice Phone: 818-233-2154
Practice Fax:

1275523888 — DR. MARTHA GULATI MD
Practice Location Address:

127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA
90048-3311

Practice Phone: 310-423-3977
Practice Fax: 310-423-0106

1174507099 — DR. NICHOLAS N NISSEN M.D.
Practice Location Address:

127 S SAN VICENTE BLVD FL 7
LOS ANGELES, CA
90048-3311

Practice Phone: 310-423-6746
Practice Fax: 310-423-7596

1821074857 — DR. AKIL ABID MERCHANT M.D.
Practice Location Address:

127 S SAN VICENTE BLVD STE A-9102
LOS ANGELES, CA
90048-3311

Practice Phone: 310-423-0161
Practice Fax: 310-423-7182

1194702159 — DR. FRANCISCO A ARABIA M.D.
Practice Location Address:

127 S SAN VICENTE BLVD , SUITE A3100
LOS ANGELES, CA
90048-3311

Practice Phone: 310-423-2831
Practice Fax:

Directions to “ JAY D. PRUETZ M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.