Provider Demographics
NPI:1164599718
Name:ADHIKARI, LEENA GAYAKWAD (OD)
Entity Type:Individual
Prefix:DR
First Name:LEENA
Middle Name:GAYAKWAD
Last Name:ADHIKARI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:11940 EAST FOOTHILL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739
Mailing Address - Country:US
Mailing Address - Phone:909-234-4222
Mailing Address - Fax:909-568-2413
Practice Address - Street 1:11940 EAST FOOTHILL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-9173
Practice Address - Country:US
Practice Address - Phone:909-980-5552
Practice Address - Fax:909-568-2413
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT11575TPL152W00000X
CAOPT11757TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA93203Medicare UPIN