Provider Demographics
NPI:1750575247
Name:LITAK, JASON (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:LITAK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2001 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 990-W
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2102
Mailing Address - Country:US
Mailing Address - Phone:310-829-4484
Mailing Address - Fax:310-829-4481
Practice Address - Street 1:2001 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 990-W
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2102
Practice Address - Country:US
Practice Address - Phone:310-829-4484
Practice Address - Fax:310-829-4481
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2025-05-22
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Provider Licenses
StateLicense IDTaxonomies
CAA118111207ND0101X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery