Provider Demographics
NPI:1508849423
Name:RHODES, LEILA N (MD)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:N
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 LA JOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-6016
Mailing Address - Country:US
Mailing Address - Phone:858-454-5557
Mailing Address - Fax:858-454-2223
Practice Address - Street 1:6525 LA JOLLA BLVD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-6016
Practice Address - Country:US
Practice Address - Phone:858-454-5557
Practice Address - Fax:858-454-2223
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2010-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ15775ZOtherGROUP SITE LOCATION
00A858770Medicare ID - Type Unspecified
I44325Medicare UPIN