Provider Demographics
NPI:1407804750
Name:PASCAL, LEROY B (MD)
Entity Type:Individual
Prefix:DR
First Name:LEROY
Middle Name:B
Last Name:PASCAL
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 1:11722 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-2543
Mailing Address - Country:US
Mailing Address - Phone:323-249-2000
Mailing Address - Fax:
Practice Address - Street 1:15248 11TH ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3704
Practice Address - Country:US
Practice Address - Phone:760-245-8691
Practice Address - Fax:760-843-6020
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG76597207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine