Provider Demographics
NPI:1275576845
Name:CELO, ERIC LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LEON
Last Name:CELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:950 S GRAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3999
Mailing Address - Country:US
Mailing Address - Phone:323-669-4346
Mailing Address - Fax:323-635-1891
Practice Address - Street 1:4618 FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1963
Practice Address - Country:US
Practice Address - Phone:323-953-7170
Practice Address - Fax:323-663-2379
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA53736207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine