Individual
JAY D. PRUETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
127 S SAN VICENTE BLVD STE A3600, LOS ANGELES, CA 90048-3311
(310) 423-1153
(310) 423-6795
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A81000
CA
2080P0202X
Pediatric Cardiology Physician
Primary
A81000
CA
Other
Enumeration date
09/22/2005
Last updated
04/14/2026
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