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General NPI Number Information
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NPI Number | 1881021848
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH CENTER OF ROSEVILLE PC
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 05/30/2014
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Provider Practice Location Address
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Address Line | 1411 SECRET RAVINE PKWY SUITE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-6041
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Country | US
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Telephone | 916-786-2002
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Fax | 916-786-2003
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Provider Business Mailing Address
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Address Line | 1411 SECRET RAVINE PKWY SUITE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-6041
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Country | US
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Telephone | 916-786-2002
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Fax | 916-786-2003
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT G LEIGH
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Credential | M.D.
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Telephone | 480-550-1750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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