Provider Demographics
NPI:1154551026
Name:LEAH M. PIKE, M.D., PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LEAH M. PIKE, M.D., PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-936-9200
Mailing Address - Street 1:PO BOX 30525
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90853-0525
Mailing Address - Country:US
Mailing Address - Phone:562-936-9200
Mailing Address - Fax:562-936-9201
Practice Address - Street 1:3742 KATELLA AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3102
Practice Address - Country:US
Practice Address - Phone:562-936-9200
Practice Address - Fax:562-936-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83814207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty