Individual
DR. MARY ANN EVA LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5229 VISTA LEJANA LN, LA CANADA, CA 91011-1860
(818) 952-9437
(818) 952-7966
Mailing address
PO BOX 848, LA CANADA, CA 91012-0848
(818) 952-9437
(818) 952-7966
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G53053
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G530530
MEDI-CAL
CA
05
—
00G530530
—
CA
01
—
G530530
LICENSE NUMBER
CA
Enumeration date
08/05/2006
Last updated
03/07/2023
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