Provider Demographics
NPI:1639182702
Name:VILTUZNIK, JANJA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANJA
Middle Name:
Last Name:VILTUZNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 E CHAPMAN AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3248
Mailing Address - Country:US
Mailing Address - Phone:714-538-6822
Mailing Address - Fax:714-280-4826
Practice Address - Street 1:2617 E CHAPMAN AVE
Practice Address - Street 2:STE 205
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3226
Practice Address - Country:US
Practice Address - Phone:714-538-6822
Practice Address - Fax:714-280-4826
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42658207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA42658CMedicare ID - Type Unspecified
CAF05513Medicare UPIN