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General NPI Number Information
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NPI Number | 1609960103
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Entity Type | Organization
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Legal Business Name | LEON LUBIANKER MD INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 14525 S BASCOM AVENUE
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City | LOS GATOS
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State | CA
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Zip | 95032
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Country | US
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Telephone | 408-356-8188
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Fax | 408-358-8388
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Provider Business Mailing Address
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Address Line | 14525 S BASCOM AVENUE
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City | LOS GATOS
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State | CA
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Zip | 95032
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Country | US
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Telephone | 408-356-8188
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Fax | 408-358-8388
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEON LUBIANKER
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Credential | MD
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Telephone | 408-356-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G33660
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License Number State | CA
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