| Leathersmd | |
|
4676 Lakeview Ave Suite 105 Yorba Linda CA 92886-2489 | |
| (714) 930-3096 | |
| Not Available |
| Full Name | Leathersmd |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4676 Lakeview Ave, Yorba Linda, California |
| Authorized Official Name and Position | Jay Leathers (OWNER) |
| Authorized Official Contact | 7149303096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leathersmd 4676 Lakeview Ave Suite 105 Yorba Linda CA 92886-2489 Ph: (714) 930-3096 | Leathersmd 4676 Lakeview Ave Suite 105 Yorba Linda CA 92886-2489 Ph: (714) 930-3096 |
| NPI Number | 1992179832 |
|---|---|
| Provider Enumeration Date | 11/16/2015 |
| Last Update Date | 11/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992179832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A121700 (California) | Primary |
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