Individual
DR. JEREMY MATTHEW BLUMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 140, LOS ANGELES, CA 90095-8344
(310) 794-7152
(310) 794-1666
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
A100479
CA
2080T0004X
Pediatric Transplant Hepatology Physician
A100479
CA
208800000X
Urology Physician
Primary
A100479
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982889622
—
CA
Enumeration date
12/31/2007
Last updated
01/07/2020
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