1609062702 NPI number — LEONARD B. ASIN, D.P.M, F.A.C.F.O. A PODIATRIC CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609062702 NPI number — LEONARD B. ASIN, D.P.M, F.A.C.F.O. A PODIATRIC CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEONARD B. ASIN, D.P.M, F.A.C.F.O. A PODIATRIC CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609062702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6200 WILSHIRE BLVD #1712
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-938-2068
Provider Business Mailing Address Fax Number:
323-934-4111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6200 WILSHIRE BLVD #1712
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-938-2068
Provider Business Practice Location Address Fax Number:
323-934-4111
Provider Enumeration Date:
09/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ASIN
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
323-938-2068

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  E1224 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)