Healthcare Provider Details

I. General information

NPI: 1811131345
Provider Name (Legal Business Name): LEO URBINELLI M.D., M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

3701 WILSHIRE BLVD SUITE 600
LOS ANGELES CA
90010-2804
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-2154
  • Fax: 323-361-3632
Mailing address:
  • Phone: 323-361-2337
  • Fax: 323-361-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA137690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: