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Individual

DR. LENO MAMMEN THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1432 S DOBSON RD STE 506, MESA, AZ 85202-4778
(480) 412-6430
Mailing address
1432 S DOBSON RD STE 506, MESA, AZ 85202-4778
(480) 412-6430

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-116909
IL
2080P0214X
Pediatric Pulmonology Physician
Primary
43248
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
532608
AZ
Enumeration date
10/01/2006
Last updated
12/02/2011
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