Provider Demographics
NPI:1548239932
Name:HOPKINS, LEAH GAIL (MD)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:GAIL
Last Name:HOPKINS
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 1:4646 BROCKTON AVE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506
Mailing Address - Country:US
Mailing Address - Phone:951-585-1800
Mailing Address - Fax:951-585-1801
Practice Address - Street 1:4646 BROCKTON AVE SUITE 201
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506
Practice Address - Country:US
Practice Address - Phone:951-585-1800
Practice Address - Fax:951-585-1801
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.123499207R00000X
WV21316207R00000X
CAC156195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2452475Medicaid
WV2006069000Medicaid
OHP01474673OtherRAILROAD MEDICARE
WV2006069000Medicaid
OHH448461Medicare PIN
P00064997Medicare PIN
OHH448460Medicare PIN
OH2452475Medicaid
OHH448460Medicare PIN
WV2006069000Medicaid
OHH448461Medicare PIN