Individual
MR. LEON EDWARD LIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
612 W DUARTE RD, STE 101, ARCADIA, CA 91007-9220
(626) 445-4850
(626) 445-0482
Mailing address
PO BOX 1047, CORVALLIS, OR 97339-1047
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G57803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300098057
RAILROAD MEDICARE
—
Enumeration date
01/23/2006
Last updated
10/10/2019
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