Individual
DR. JOSEPH M. LEEBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15025 INNOVATION DR, SAN DIEGO, CA 92128-3409
(858) 554-2626
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-2626
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G56735
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G567350
—
CA
01
—
B069
CHAMPUS
—
01
—
B189
CHAMPUS
—
01
—
P00111370
RAILROAD MEDICARE
—
Enumeration date
08/31/2006
Last updated
04/12/2017
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