Organization
LELAND J FOSHAG, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LELAND JAY FOSHAG M.D. (PRESIDENT)
(818) 907-7828
Entity
Organization
Contact information
Practice address
11818 WILSHIRE BLVD STE 200, LOS ANGELES, CA 90025-6647
(818) 907-7828
(818) 907-6157
Mailing address
15720 VENTURA BLVD STE 227, ENCINO, CA 91436-2978
(818) 907-7828
(818) 907-6157
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
G61645
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659441293
NPI- INDIVIDUAL
CA
Enumeration date
11/20/2012
Last updated
11/20/2012
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