Provider Demographics
NPI:1154908887
Name:MEJIA, LEONARDO IVAN (DO)
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:IVAN
Last Name:MEJIA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5301 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2805
Mailing Address - Country:US
Mailing Address - Phone:520-324-2308
Mailing Address - Fax:520-324-2051
Practice Address - Street 1:9348 E RITA RD STE 140
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-6301
Practice Address - Country:US
Practice Address - Phone:520-324-1036
Practice Address - Fax:520-324-1035
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2025-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ011127207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine