Individual
DR. LEONID M. KATKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15301 WARREN SHINGLE RD, 9TH MDG, BEALE AFB, CA 95903-1907
(530) 634-4730
Mailing address
15301 WARREN SHINGLE RD, 9TH MDG, BEALE AFB, CA 95903-1907
(530) 634-4730
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
77555
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77555
MEDICAL LICENSE
OH
Enumeration date
10/14/2005
Last updated
02/25/2008
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