Provider Demographics
NPI:1093931123
Name:LEAL, MICHAEL HENRY (PT, MPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:HENRY
Last Name:LEAL
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9353 IMPERIAL HWY
Mailing Address - Street 2:PM & R GARDEN BLDG 3RD FLOOR
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2812
Mailing Address - Country:US
Mailing Address - Phone:562-657-4803
Mailing Address - Fax:
Practice Address - Street 1:9353 IMPERIAL HWY
Practice Address - Street 2:PM & R GARDEN BLDG 3RD FLOOR
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2812
Practice Address - Country:US
Practice Address - Phone:562-657-4803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT284012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic