Individual
MR. LEROY W VAUGHN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
323 N PRAIRIE AVE STE 217, INGLEWOOD, CA 90301-4504
(310) 671-0909
(310) 412-0066
Mailing address
323 N PRAIRIE AVE STE 217, INGLEWOOD, CA 90301-4504
(310) 671-0909
(310) 412-0066
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A30576
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A00305761
—
CA
Enumeration date
10/18/2006
Last updated
10/05/2011
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