MEDICARE: DR. HEINZ-JOSEF LENZ M.D.

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
1	207RH0003X	Hematology & Oncology Physician	A63854	CA
2	207RX0202X	Medical Oncology Physician	A63854	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CE1617	OTHER	CA	GROUP RAILROAD MEDICARE
8	830005979	OTHER	CA	RAILROAD MEDICARE
9	W18762	OTHER	CA	MEDICARE GROUP ID
11	W11675	OTHER	CA	GROUP MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1902846306	OTHER	CA	GROUP NPI
3	GR0100430	OTHER	CA	GROUP MEDICAL
4	00A638540197	OTHER	CA	CAL OPTIMA
5	1356390009	OTHER	CA	GROUP NIP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	00A638540	OTHER	CA	BLUE SHIELD
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700814209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEINZ-JOSEF LENZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 EASTLAKE AVE.
Second Line	:	NOR 8302E
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-0000
Country	:	US
Telephone Number	:	323-865-3105
Fax Number	:	323-865-0061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	11/27/2023

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