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NPI Code Detail

MEDICARE: GUIDO A LEON MD PA

MEDICARE: GUIDO A LEON MD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548308208
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUIDO A LEON MD PA
Provider Business Mailing Address
First Line : PO BOX 1560
Second Line :
City : LAS CRUCES
State : NM
Zip : 88004-1560
Country : US
Telephone Number : 505-647-8366
Fax Number : 505-647-8381
Provider Business Practice Location Address
First Line : 1255 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4748
Country : US
Telephone Number : 575-522-0300
Fax Number : 505-522-4366
Authorized Official
Title or Position : OWNER
Name : DR. GUIDO LEON
Credential : MD
Telephone Number : 575-522-0300
Provider Enumeration Date : 02/02/2007
Last Update Date : 08/24/2023

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