Provider Demographics
NPI:1598850174
Name:MUELLER, LEIGH ALISON (DO)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ALISON
Last Name:MUELLER
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 1:4145 CLARES ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-2053
Mailing Address - Country:US
Mailing Address - Phone:831-476-1933
Mailing Address - Fax:831-476-2677
Practice Address - Street 1:4145 CLARES ST
Practice Address - Street 2:SUITE A
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2053
Practice Address - Country:US
Practice Address - Phone:831-476-1933
Practice Address - Fax:831-476-2677
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics