Organization
JEFFEY O LEACH, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA ROBERSON (MEDICARE BILLING SPECIALIST)
(760) 941-9844
Entity
Organization
Contact information
Practice address
2067 W VISTA WAY, SUITE 200, VISTA, CA 92083-6031
(760) 941-9844
(760) 630-5716
Mailing address
2067 W VISTA WAY, SUITE 200, VISTA, CA 92083-6031
(760) 941-9844
(960) 630-5716
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G30939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG309390
—
CA
Enumeration date
06/24/2006
Last updated
01/25/2011
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