Individual provider · NPI-1

Dr. Jeremy Matthew Blumberg, M.D.

Urology · Los Angeles, CA

NPI number1982889622
StatusActive
Last updated in NPPESJan 7, 2020

Details

NPI
1982889622
Entity type
Individual (NPI-1)
Name
Dr. Jeremy Matthew Blumberg
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Dec 31, 2007
Certification date
Jan 7, 2020
Last updated
Jan 7, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208800000X UrologyA100479CAYes
2080T0004X Pediatrics, Pediatric Transplant HepatologyA100479CA
204F00000X Transplant SurgeryA100479CA

Practice location

200 Ucla Medical Plz Ste 140
Los Angeles, CA 90095-8344

Phone 310-794-7152 · Fax 310-794-1666

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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