Provider Demographics
NPI:1477692382
Name:LEONOR, CRISANTO O (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISANTO
Middle Name:O
Last Name:LEONOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:16740 LAKE KNOLL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-9551
Mailing Address - Country:US
Mailing Address - Phone:909-951-6880
Mailing Address - Fax:909-421-9466
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5230
Practice Address - Country:US
Practice Address - Phone:909-421-9465
Practice Address - Fax:909-421-9466
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC38900207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine