Individual
DR. LELAND DALE RONNINGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-6054
(714) 456-5342
Mailing address
101 THE CITY DR S, BLDG 26 RT 81, ORANGE, CA 92868-3201
(714) 456-6054
(714) 456-5342
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G85070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G850700
BLUE SHIELD
CA
05
—
00G850700
—
CA
Enumeration date
08/30/2006
Last updated
07/08/2007
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