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1831021195 NPI number — CRYSTAL LITAK, M.D., INC

NPI Number: 1831021195
Health Care Provider/Practitioner: CRYSTAL LITAK, M.D., INC

Information about “1831021195” NPI (CRYSTAL LITAK, M.D., INC) exists in 1831021195 in HTML format HTML  |  1831021195 in plain Text format TXT  |  1831021195 in PDF (Portable Document Format) PDF  |  1831021195 in an XML format XML  formats.

NPI Number : 1831021195 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831021195",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CRYSTAL LITAK, M.D., INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2021 SANTA MONICA BLVD STE 710",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA MONICA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90404-2223",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-315-0131",
    "MailingAddressFaxNumber": "310-453-0133",
    "FirstLinePracticeLocationAddress": "2021 SANTA MONICA BLVD STE 710",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SANTA MONICA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90404-2223",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-315-0131",
    "PracticeLocationAddressFaxNumber": "310-453-0133",
    "EnumerationDate": "06/01/2026",
    "LastUpdateDate": "06/01/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LITAK",
    "AuthorizedOfficialFirstName": "CRYSTAL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "FAMILY MEDICINE PHYSICIAN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "760-220-8056",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP2300X",
        "TaxonomyName": "Primary Care Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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