Provider Demographics
NPI:1619984234
Name:BLUMENKRANTZ, MICHAEL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:BLUMENKRANTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 1207
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2015
Mailing Address - Country:US
Mailing Address - Phone:310-289-9824
Mailing Address - Fax:310-277-3659
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 1207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2015
Practice Address - Country:US
Practice Address - Phone:310-289-9824
Practice Address - Fax:310-277-3659
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2013-07-16
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Provider Licenses
StateLicense IDTaxonomies
CAG17734207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G177341Medicaid
CA00G177341Medicaid