Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A117476 | CA |
N | 208000000X | Pediatrician | 244769 | NY |
N | 208000000X | Pediatrician | A117476 | CA |
NPI | 1003074469 |
---|---|
Provider Name | Dr. Stephanie Ann Leonard |
First Address | San Diego, CA 92123-4802 |
Second Address | San Diego, CA 92123-2758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2008 |
Last Update Date | 04/10/2011 |