Provider Demographics
NPI:1467492041
Name:GILBERG-LENZ, SUZANNE B (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:B
Last Name:GILBERG-LENZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 WILSHIRE BLVD
Mailing Address - Street 2:#511
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2007
Mailing Address - Country:US
Mailing Address - Phone:310-657-1600
Mailing Address - Fax:310-659-3299
Practice Address - Street 1:8920 WILSHIRE BLVD
Practice Address - Street 2:#511
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2007
Practice Address - Country:US
Practice Address - Phone:310-657-1600
Practice Address - Fax:310-659-3299
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65856174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA65856OtherSTATE LICENSE