Individual
MR. LELAND MARK LERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
3801 MIRANDA AVE # 126MPD, PALO ALTO, CA 94304-1207
(650) 493-5000
(650) 617-2634
Mailing address
1043 EASTWOOD DR, LOS ALTOS, CA 94024-5018
(650) 938-0100
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU1704
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09118665
ASHA CERTIFICATION
CA
01
—
AU1704
AUDIOLOGY LICENSE
CA
01
—
HA3587
HEARING AID LICENS
CA
Enumeration date
08/30/2006
Last updated
07/08/2007
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