Provider Demographics
NPI:1376743229
Name:LEONEL A HUNT MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:LEONEL A HUNT MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-423-9834
Mailing Address - Street 1:8306 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 597
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2304
Mailing Address - Country:US
Mailing Address - Phone:310-423-9834
Mailing Address - Fax:
Practice Address - Street 1:444 S SAN VICENTE BLVD
Practice Address - Street 2:SUITE #800
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4165
Practice Address - Country:US
Practice Address - Phone:310-423-9834
Practice Address - Fax:310-423-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72199207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17985Medicare PIN