Provider Demographics
NPI:1982884904
Name:LENTZNER, JAY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:ROBERT
Last Name:LENTZNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1630 PARK AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3869
Mailing Address - Country:US
Mailing Address - Phone:562-597-1859
Mailing Address - Fax:562-597-8210
Practice Address - Street 1:1630 PARK AVE APT 5
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3869
Practice Address - Country:US
Practice Address - Phone:562-597-1859
Practice Address - Fax:562-597-8210
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA932102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry