Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD045594L | PA |
Y | 2080P0210X | Pediatric Nephrologist | G132734 | CA |
N | 2080P0210X | Pediatric Nephrologist | MD045594L | PA |
NPI | 1033133046 |
---|---|
Provider Name | Mary B Leonard |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 02/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001647480 | (05) | PA |
7291604 | (05) | NJ |
G59658 | (02) |