Provider Demographics
NPI:1548432685
Name:ROGER K. LEIR
Entity Type:Organization
Organization Name:ROGER K. LEIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:STEENBURGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-495-2613
Mailing Address - Street 1:3801 OLD CONEJO RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1030
Mailing Address - Country:US
Mailing Address - Phone:805-495-2613
Mailing Address - Fax:805-376-2618
Practice Address - Street 1:268 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8223
Practice Address - Country:US
Practice Address - Phone:805-495-2613
Practice Address - Fax:805-376-2618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROGER K. LEIR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-28
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1171C332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0265970002Medicare NSC
CAT10806Medicare UPIN