Provider Demographics
NPI:1700814209
Name:LENZ, HEINZ-JOSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:HEINZ-JOSEF
Middle Name:
Last Name:LENZ
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE.
Practice Address - Street 2:NOR 8302E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-0000
Practice Address - Country:US
Practice Address - Phone:323-865-3105
Practice Address - Fax:323-865-0061
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63854207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902846306OtherGROUP NPI
CACE1617OtherGROUP RAILROAD MEDICARE
CAGR0100430OtherGROUP MEDICAL
CA00A638540197OtherCAL OPTIMA
CA1356390009OtherGROUP NIP
CAGR0016910OtherGROUP MEDICAID PIN
CA00A638540OtherBLUE SHIELD
CA830005979OtherRAILROAD MEDICARE
CAW18762OtherMEDICARE GROUP ID
CA00A638540Medicaid
CAW11675OtherGROUP MEDICARE PIN
CA1902846306OtherGROUP NPI
CA00A638540Medicaid