Provider Demographics
NPI:1598150047
Name:LEONTI, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LEONTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 OCEAN AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6050
Mailing Address - Country:US
Mailing Address - Phone:310-849-9567
Mailing Address - Fax:310-693-8063
Practice Address - Street 1:8830 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4833
Practice Address - Country:US
Practice Address - Phone:310-849-9567
Practice Address - Fax:310-693-8063
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 42363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist