Provider Demographics
NPI:1124086590
Name:LEONARD, JOSEPH FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5525 GROSSMONT CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3009
Mailing Address - Country:US
Mailing Address - Phone:619-644-6500
Mailing Address - Fax:619-644-6526
Practice Address - Street 1:5525 GROSSMONT CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3009
Practice Address - Country:US
Practice Address - Phone:619-644-6500
Practice Address - Fax:619-644-6526
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330885096OtherOFFICE IRS NUMBER
CAG34516OtherSTATE LICENSE #
CAG34516OtherSTATE LICENSE #
CAWG34516GMedicare ID - Type UnspecifiedMEDICARE
CAW14898Medicare UPIN