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General NPI Number Information
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NPI Number | 1831576248
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Entity Type | Organization
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Legal Business Name | LEENA BADHWAR MD INC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 240 OAK MEADOW DR
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City | LOS GATOS
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State | CA
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Zip | 95032-4452
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Country | US
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Telephone | 408-358-8958
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Fax | 408-884-8012
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Provider Business Mailing Address
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Address Line | 240 OAK MEADOW DR
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City | LOS GATOS
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State | CA
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Zip | 95032-4452
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Country | US
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Telephone | 408-358-8958
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Fax | 408-884-8012
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. LEENA BADHWAR
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Credential | MD
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Telephone | 408-705-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A53066
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License Number State | CA
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