Healthcare Provider Details

I. General information

NPI: 1316918170
Provider Name (Legal Business Name): JEFFREY LITZINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4132 KATELLA AVE STE 200
LOS ALAMITOS CA
90720-3496
US

IV. Provider business mailing address

809 WILD TURKEY PL
WILMINGTON NC
28405-4265
US

V. Phone/Fax

Practice location:
  • Phone: 562-312-1777
  • Fax: 562-318-2257
Mailing address:
  • Phone: 714-862-9981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number122952
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number200301488
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA66706
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number122952
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA66706
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number200301488
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: