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General NPI Number Information
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NPI Number | 1245249424
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Entity Type | Individual
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Provider Name | MARY ANN EVA LEAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5229 VISTA LEJANA LN
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City | LA CANADA
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State | CA
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Zip | 91011-1860
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Country | US
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Telephone | 818-952-9437
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Fax | 818-952-7966
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Provider Business Mailing Address
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Address Line | PO BOX 848
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City | LA CANADA
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State | CA
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Zip | 91012-0848
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Country | US
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Telephone | 818-952-9437
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Fax | 818-952-7966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | G53053
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License Number State | CA
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