NPIMap

Organization Active NPI

Kleynberg Medical Clinic Inc

  • Hematology & Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1568570109
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
KLEYNBERG MEDICAL CLINIC INC
Practice address
6221 Wilshire Blvd
Suite 504
Los Angeles, CA 90048-5201
Phone
(323) 965-9995
Fax
(323) 965-5678
NPI assigned
Aug 25, 2006
Last updated
Nov 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Leonid M Kleynberg, M.D.NPI 1891750212
Title
Ceo / President
Phone
(323) 965-9995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

6221 Wilshire Blvd
Suite 504
Los Angeles, CA 90048-5201

Mailing address

6221 Wilshire Blvd
Suite 504
Los Angeles, CA 90048-5201
Phone (323) 965-9995

Other identifiers 1

IdentifierTypeStateIssuer
GR0098250MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000533 CA Part B Supplier - Clinic/Group Practice 8426947698 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Kleynberg Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1568570109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE 504",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-965-9995",
            "fax_number": "323-965-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE 504",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-965-9995",
            "fax_number": "323-965-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEYNBERG MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "KLEYNBERG",
        "authorized_official_first_name": "LEONID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO / PRESIDENT",
        "authorized_official_telephone_number": "323-965-9995",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.