Provider Demographics
NPI:1265639728
Name:KAO, LEON (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:KAO
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 1:19851 OBSERVATION DR STE 375
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4151
Mailing Address - Country:US
Mailing Address - Phone:301-972-3709
Mailing Address - Fax:
Practice Address - Street 1:19851 OBSERVATION DR STE 375
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4151
Practice Address - Country:US
Practice Address - Phone:301-972-3709
Practice Address - Fax:301-515-3612
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0074337207KA0200X, 207KA0200X
TXBP10038062390200000X
VA0101245767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD97730501OtherBCBS OF MARYLAND
VA1049243OtherSOUTHERN HEALTH/COVENTRY
MD5753777OtherCIGNA
MD8739985OtherAETNA HMO
MD227674YDBHOtherMEDICARE
VAP00735855OtherRAILROAD MEDICARE
MD3090008OtherMDIPA/OPTIMUM CHOICE
MD9117376OtherAETNA PPO
MDC149-0015OtherCAREFIRST BLUE CHOICE
VA1265639728Medicaid
VA302011OtherANTHEM
MD8739985OtherAETNA HMO