Provider Demographics
NPI:1679670483
Name:LEON, LUIS R (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:LEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9192 W UNION HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8208
Mailing Address - Country:US
Mailing Address - Phone:602-374-4101
Mailing Address - Fax:024-410-5226
Practice Address - Street 1:3411 N 5TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3812
Practice Address - Country:US
Practice Address - Phone:602-374-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAO690912086S0129X
AZ350272086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery