Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A45401 | CA |
NPI | 1003844945 |
---|---|
Provider Name | Dr. Heinz Jurgen Lenz |
First Address | La Jolla, CA 92037-1224 |
Second Address | La Jolla, CA 92037-1224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F00239 | (02) | CA |