Healthcare Provider Details

I. General information

NPI: 1114337326
Provider Name (Legal Business Name): LEO EICKHOFF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2147 COURT ST
REDDING CA
96001-2531
US

IV. Provider business mailing address

2147 COURT ST
REDDING CA
96001-2531
US

V. Phone/Fax

Practice location:
  • Phone: 530-243-8667
  • Fax: 530-243-8742
Mailing address:
  • Phone: 530-243-8667
  • Fax: 530-243-8742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEO EDWARD EICKHOFF III
Title or Position: OWNER
Credential: MD
Phone: 530-243-8667