Healthcare Provider Details

I. General information

NPI: 1477692069
Provider Name (Legal Business Name): ERICA LEIGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 03/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 HILLTOP MALL RD SUITE 305
RICHMOND CA
94806-1947
US

IV. Provider business mailing address

2970 HILLTOP MALL RD SUITE 305
RICHMOND CA
94806-1947
US

V. Phone/Fax

Practice location:
  • Phone: 510-222-5437
  • Fax:
Mailing address:
  • Phone: 510-222-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG080607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: