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General NPI Number Information
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NPI Number | 1215382361
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Entity Type | Organization
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Legal Business Name | LEOPOLDO PUGA
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 3550 Q ST SUITE #205
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1662
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Country | US
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Telephone | 661-327-7842
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Fax | 661-327-4757
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Provider Business Mailing Address
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Address Line | PO BOX 22281
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City | BAKERSFIELD
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State | CA
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Zip | 93390-2281
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Country | US
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Telephone | 661-327-7842
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Fax | 661-327-4757
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEOPOLDO PUGA
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Credential | M.D.
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Telephone | 661-327-7842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A85474
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License Number State | CA
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