MEDICARE: LEONARD MARIO SAPUTO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G121160	CA

General Provider Information

NPI Number	:	1295825438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARD MARIO SAPUTO MD

Provider Business Mailing Address
First Line	:	3799 MT DIABLO BLVD
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-3538
Country	:	US
Telephone Number	:	925-962-3799
Fax Number	:	925-962-3700

Provider Business Practice Location Address
First Line	:	3799 MT DIABLO BLVD
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-3538
Country	:	US
Telephone Number	:	925-962-3799
Fax Number	:	925-962-3700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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