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NPI Code Detail

MEDICARE: MR. JONATHAN B. BLITZER MD

MEDICARE: MR. JONATHAN B. BLITZER MD
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
1174400000XSpecialistG062021CA
2207RH0003XHematology & Oncology PhysicianG062021CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912967324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN B. BLITZER MD
Provider Business Mailing Address
First Line : 2810 LONG BEACH BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-1558
Country : US
Telephone Number : 562-933-1877
Fax Number :
Provider Business Practice Location Address
First Line : 2810 LONG BEACH BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-1558
Country : US
Telephone Number : 562-933-1877
Fax Number : 562-933-1886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 01/03/2018

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