Provider Demographics
NPI:1437458213
Name:LEARY, MICHELE F (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:F
Last Name:LEARY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 CALIFORNIA BLVD
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549
Mailing Address - Country:US
Mailing Address - Phone:510-306-7435
Mailing Address - Fax:
Practice Address - Street 1:2201 COURAGE DRIVE
Practice Address - Street 2:MS 9-100
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-784-2010
Practice Address - Fax:707-784-1495
Is Sole Proprietor?:No
Enumeration Date:2011-03-20
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10254207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine