Provider Demographics
NPI:1528320942
Name:MARCOTRIGIANO, LEANNE T (MD)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:T
Last Name:MARCOTRIGIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6916 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1363
Mailing Address - Country:US
Mailing Address - Phone:814-280-1648
Mailing Address - Fax:
Practice Address - Street 1:5461 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601
Practice Address - Country:US
Practice Address - Phone:510-532-0918
Practice Address - Fax:510-532-0956
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252016207Q00000X
CAA142517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine