Provider Demographics
NPI:1114940285
Name:SCHULKIND, LEONARD NEIL (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:NEIL
Last Name:SCHULKIND
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 1:1353 TRIESTE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3949
Mailing Address - Country:US
Mailing Address - Phone:619-223-2351
Mailing Address - Fax:619-223-5062
Practice Address - Street 1:4490 FANUEL ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4292
Practice Address - Country:US
Practice Address - Phone:858-274-9116
Practice Address - Fax:858-274-9161
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43016207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43016Medicaid
CAA43016Medicaid