Provider Demographics
NPI:1659312536
Name:PUGA, LEOPOLDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEOPOLDO
Middle Name:
Last Name:PUGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22281
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2281
Mailing Address - Country:US
Mailing Address - Phone:661-327-7842
Mailing Address - Fax:866-547-8781
Practice Address - Street 1:8327 BRIMHALL RD STE 701
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-4050
Practice Address - Country:US
Practice Address - Phone:661-327-7842
Practice Address - Fax:866-547-8781
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85474207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A854740Medicaid
CA00A854740Medicaid
CAP00290606Medicare PIN
CAI30581Medicare UPIN