Organization
LEPORT EDUCATION
Active
Other names
LePort Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER C LEPORT M.D. (CEO)
(714) 912-9380
Entity
Organization
Contact information
Practice address
18111 BROOKHURST ST, SUITE 5600, FOUNTAIN VALLEY, CA 92708-6728
(714) 912-9380
(714) 912-9381
Mailing address
18111 BROOKHURST ST, SUITE 5600, FOUNTAIN VALLEY, CA 92708-6728
(714) 912-9380
(714) 912-9381
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G47193
CA
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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