Provider Demographics
NPI:1942645221
Name:BLUMBERG, LESLEY ZLOTTA (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:ZLOTTA
Last Name:BLUMBERG
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 1:9370 FLICKER WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-1728
Mailing Address - Country:US
Mailing Address - Phone:310-278-8641
Mailing Address - Fax:
Practice Address - Street 1:9370 FLICKER WAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-1728
Practice Address - Country:US
Practice Address - Phone:310-278-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27325207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology