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NPI Code Detail

MEDICARE: DR. JAY ROBERT LENTZNER M.D.

MEDICARE: DR. JAY ROBERT LENTZNER 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
12084P0800XPsychiatry PhysicianA93210CA

General Provider Information

NPI Number : 1982884904
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY ROBERT LENTZNER M.D.
Provider Business Mailing Address
First Line : 1630 PARK AVE APT 5
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-3869
Country : US
Telephone Number : 562-597-1859
Fax Number : 562-597-8210
Provider Business Practice Location Address
First Line : 1630 PARK AVE APT 5
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-3869
Country : US
Telephone Number : 562-597-1859
Fax Number : 562-597-8210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2007
Last Update Date : 08/21/2008

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