Individual
DR. LUIS DIEGO LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1115 WEST ST, SOUTHINGTON, CT 06489-6025
(860) 679-2766
Mailing address
UCONN MEDICAL GROUP, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-8400
(860) 679-8188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049613
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
049613
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008036398
—
CT
Enumeration date
08/17/2009
Last updated
09/12/2022
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