Individual
MR. LEON A. MOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
475 S DOBSON RD, CHANDLER, AZ 85224-5605
(480) 963-4561
Mailing address
3484 E PAGE AVE, GILBERT, AZ 85234-4239
(602) 320-5944
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2562
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
623977
—
AZ
Enumeration date
07/24/2006
Last updated
10/29/2012
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