Provider Demographics
NPI:1265503510
Name:HUNTER, LEIGH WACHA (NP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:WACHA
Last Name:HUNTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 ELM AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1652
Mailing Address - Country:US
Mailing Address - Phone:310-784-5800
Mailing Address - Fax:310-530-9811
Practice Address - Street 1:2653 ELM AVE STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1652
Practice Address - Country:US
Practice Address - Phone:562-728-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396544163W00000X
CA15209363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse