Provider Demographics
NPI:1891750212
Name:KLEYNBERG, LEONID (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONID
Middle Name:
Last Name:KLEYNBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5201
Mailing Address - Country:US
Mailing Address - Phone:323-965-9995
Mailing Address - Fax:323-965-5678
Practice Address - Street 1:6221 WILSHIRE BLVD
Practice Address - Street 2:SUITE 504
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5201
Practice Address - Country:US
Practice Address - Phone:323-965-9995
Practice Address - Fax:323-965-5678
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76900207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A769000Medicaid
CAH06887Medicare UPIN
CA00A769000Medicaid