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General NPI Number Information
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NPI Number | 1356060776
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Entity Type | Organization
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Legal Business Name | LEOBARDO CARRANZA DPM PLLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 5555 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-4622
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Country | US
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Telephone | 602-865-5604
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Fax |
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Provider Business Mailing Address
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Address Line | 12806 W ASH ST
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City | EL MIRAGE
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State | AZ
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Zip | 85335-6274
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LEOBARDO CARRANZA
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Credential | DPM
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Telephone | 270-903-1262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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