Individual
LELAND I COLLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 568-4330
(760) 568-6470
Mailing address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 773-1451
(760) 773-1239
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
5601003570
MI
363AS0400X
Surgical Physician Assistant
PA602
ID
363AS0400X
Surgical Physician Assistant
Primary
PA61588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807423000
—
ID
Enumeration date
04/18/2006
Last updated
02/22/2023
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