Provider Demographics
NPI:1447565841
Name:LEBLANC, MARTIN RAOUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:RAOUL
Last Name:LEBLANC
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 1:45 CASTRO ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1022
Mailing Address - Country:US
Mailing Address - Phone:415-565-6897
Mailing Address - Fax:415-864-1654
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:SUITE 121
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1022
Practice Address - Country:US
Practice Address - Phone:415-565-6897
Practice Address - Fax:415-864-1654
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1132622082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand