Provider Demographics
NPI:1558672741
Name:LEONE, EVELYNE SARAH (DO)
Entity Type:Individual
Prefix:DR
First Name:EVELYNE
Middle Name:SARAH
Last Name:LEONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11040 SANTA MONICA BLVD
Mailing Address - Street 2:#370
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:305-282-6409
Mailing Address - Fax:
Practice Address - Street 1:11040 SANTA MONICA BLVD
Practice Address - Street 2:S 1505
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7515
Practice Address - Country:US
Practice Address - Phone:305-282-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2168207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine