Healthcare Provider Details

I. General information

NPI: 1235151796
Provider Name (Legal Business Name): RONALD S LEUCHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
LOS ANGELES CA
90048-1804
US

IV. Provider business mailing address

PO BOX 3736
BEVERLY HILLS CA
90212-0736
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-0701
  • Fax: 310-967-1142
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:
Title or Position:
Credential:
Phone: