Individual
LEON BACHOURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1334 W COVINA BLVD STE 201, SAN DIMAS, CA 91773-3211
(909) 592-2078
(909) 592-0279
Mailing address
1334 W COVINA BLVD STE 201, SAN DIMAS, CA 91773-3211
(909) 592-2078
(909) 592-0279
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A361860
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A361860
—
CA
Enumeration date
11/06/2006
Last updated
07/08/2007
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