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NPI Code Detail

MEDICARE: LEADING MEDICAL TECHNOLOGIES, INC.

MEDICARE: LEADING MEDICAL TECHNOLOGIES, INC.
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
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1407217342
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEADING MEDICAL TECHNOLOGIES, INC.
Provider Business Mailing Address
First Line : 11141 NILE RIVER CT
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-2941
Country : US
Telephone Number : 916-717-3670
Fax Number : 916-246-0575
Provider Business Practice Location Address
First Line : 11216 TRINITY RIVER DR
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-2968
Country : US
Telephone Number : 916-635-6161
Fax Number : 916-635-5145
Authorized Official
Title or Position : CHIEF MEDICAL DIRECTOR
Name : JAMES MARTEL
Credential : MD
Telephone Number : 916-635-6161
Provider Enumeration Date : 03/18/2016
Last Update Date : 03/18/2016

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