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1679670483 NPI number — LUIS R. LEON MD

NPI Number: 1679670483
Health Care Provider/Practitioner: LUIS R. LEON MD

Information about “1679670483” NPI (LUIS R. LEON MD) exists in 1679670483 in HTML format HTML  |  1679670483 in plain Text format TXT  |  1679670483 in PDF (Portable Document Format) PDF  |  1679670483 in an XML format XML  formats.

NPI Number : 1679670483 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679670483",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEON",
    "FirstName": "LUIS",
    "MiddleName": "R.",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9192 W UNION HILLS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEORIA",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85382-8208",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-374-4101",
    "MailingAddressFaxNumber": "24-410-5226",
    "FirstLinePracticeLocationAddress": "3411 N 5TH AVE STE 301",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85013-3812",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-374-4101",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/20/2006",
    "LastUpdateDate": "08/28/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": "AO69091",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": "35027",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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