Provider Demographics
NPI:1275768103
Name:HOUSTON, LEAH C (MD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:C
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:C
Other - Last Name:REY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 LAGUNA ST
Mailing Address - Street 2:# 152
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5667
Mailing Address - Country:US
Mailing Address - Phone:305-439-4845
Mailing Address - Fax:
Practice Address - Street 1:400 LAGUNA ST
Practice Address - Street 2:# 152
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5667
Practice Address - Country:US
Practice Address - Phone:305-439-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62879390200000X
FLME112696207P00000X
CAA136896207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program