Provider Demographics
NPI:1427405315
Name:MORGAN, LEAH MARIE TINKHAM (LAC DAOM)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MARIE TINKHAM
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LAC DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4449 CONRAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1916
Mailing Address - Country:US
Mailing Address - Phone:518-892-1327
Mailing Address - Fax:
Practice Address - Street 1:2852 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-1407
Practice Address - Country:US
Practice Address - Phone:619-282-8068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16986171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist