Healthcare Provider Details

I. General information

NPI: 1922325976
Provider Name (Legal Business Name): RONALD S. LEUCHTER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD #AC1111
LOS ANGELES CA
90048-0750
US

IV. Provider business mailing address

PO BOX 3736
BEVERLY HILLS CA
90212-0736
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-3779
  • Fax: 310-659-9039
Mailing address:
  • Phone: 310-652-3779
  • Fax: 310-659-9039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA26569
License Number StateCA

VIII. Authorized Official

Name: DR. RONALD S LEUCHTER
Title or Position: PRESIDENT
Credential: MD
Phone: 310-652-3779