Provider Demographics
NPI:1053331173
Name:BARTON, LEON (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:BARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 N FLORES ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2611
Mailing Address - Country:US
Mailing Address - Phone:323-651-5371
Mailing Address - Fax:323-521-5113
Practice Address - Street 1:449 N FLORES ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-2611
Practice Address - Country:US
Practice Address - Phone:323-651-5371
Practice Address - Fax:323-521-5113
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A355470Medicaid
CAA35547Medicare ID - Type Unspecified
CA00A355470Medicaid
HA35547AMedicare ID - Type Unspecified
HA35547Medicare ID - Type Unspecified