Provider Demographics
NPI:1346362605
Name:LITTLE, JOHN ZEBULON III (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ZEBULON
Last Name:LITTLE
Suffix:III
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11620 WILSHIRE BLVD
Mailing Address - Street 2:#715
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1706
Mailing Address - Country:US
Mailing Address - Phone:310-471-7712
Mailing Address - Fax:
Practice Address - Street 1:11620 WILSHIRE BLVD
Practice Address - Street 2:#715
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1706
Practice Address - Country:US
Practice Address - Phone:310-471-7712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA738312084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry