Provider Demographics
NPI:1609062702
Name:LEONARD B. ASIN, D.P.M, F.A.C.F.O. A PODIATRIC CORPORATION
Entity Type:Organization
Organization Name:LEONARD B. ASIN, D.P.M, F.A.C.F.O. A PODIATRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ASIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:323-938-2068
Mailing Address - Street 1:6200 WILSHIRE BLVD #1712
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:323-938-2068
Mailing Address - Fax:323-934-4111
Practice Address - Street 1:6200 WILSHIRE BLVD #1712
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:323-938-2068
Practice Address - Fax:323-934-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1224213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA770838Medicare UPIN