Individual
GARY JORDAN LEEDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3111 PROFESSIONAL DR, AUBURN, CA 95603-2456
(530) 885-5618
Mailing address
3754 COPPER PENNY LN, AUBURN, CA 95602-9276
(530) 889-8659
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A043004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A430040
MEDI-CAL
CA
Enumeration date
11/29/2005
Last updated
11/16/2007
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