MEDICARE: CRYSTAL LITAK, M.D., INC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1831021195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRYSTAL LITAK, M.D., INC

Provider Business Mailing Address
First Line	:	2021 SANTA MONICA BLVD STE 710
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2223
Country	:	US
Telephone Number	:	310-315-0131
Fax Number	:	310-453-0133

Provider Business Practice Location Address
First Line	:	2021 SANTA MONICA BLVD STE 710
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2223
Country	:	US
Telephone Number	:	310-315-0131
Fax Number	:	310-453-0133

Authorized Official
Title or Position	:	FAMILY MEDICINE PHYSICIAN
Name	:	CRYSTAL LITAK
Credential	:	MD
Telephone Number	:	760-220-8056

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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