Dr. Richard D Leathers
Oral & Maxillofacial Surgeon
12021 Wilmington Ave
Los Angeles
, California 90059-3019
Dr. Richard D Leathers
Oral & Maxillofacial Surgeon
12021 Wilmington Ave
Los Angeles
, California 90059-3019
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Richard D Leathers
- 4054 Athenian Way
- Los Angeles, CA
- Zip : 90043-1618
- Phone :
Second Address
- Dr. Richard D Leathers
- 12021 Wilmington Ave
- Los Angeles, CA
- Zip : 90059-3019
- Fax : (310) 763-8909
- Phone : (310) 668-4515
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | DK28026 | CA |
National Provider Identifier
| NPI | 1588790307 |
|---|---|
| Provider Name | Dr. Richard D Leathers |
| First Address | Los Angeles, CA 90043-1618 |
| Second Address | Los Angeles, CA 90059-3019 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T70448 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.