Provider Demographics
NPI:1659013241
Name:THOMPSON, JOHN WARREN LENZI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WARREN LENZI
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL PLAZA SUITE B200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-6975
Mailing Address - Country:US
Mailing Address - Phone:310-794-1195
Mailing Address - Fax:
Practice Address - Street 1:300 MEDICAL PLAZA SUITE B200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-794-1195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program