Provider Demographics
NPI:1215948740
Name:PIKE, LEAH M (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:M
Last Name:PIKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5357 E THE TOLEDO UNIT A
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-7222
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 2:303
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG83814207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1154551026Medicaid
FL256066600Medicaid
FL256066600Medicaid
46370ZMedicare ID - Type Unspecified