Healthcare Provider Details

I. General information

NPI: 1801992102
Provider Name (Legal Business Name): LONNIE KAYE ZELTZER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MED PLAZA SUITE 265
LOS ANGELES CA
90095
US

IV. Provider business mailing address

10833 LE CONTE AVENUE 22-464 MDCC
LOS ANGELES CA
90095
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-0731
  • Fax: 310-794-2104
Mailing address:
  • Phone: 310-825-0731
  • Fax: 310-794-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG21507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: