Provider Demographics
NPI:1679509269
Name:DACANAY, LEONARDO M (MD)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:M
Last Name:DACANAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1936 UNIVERSITY AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1003
Mailing Address - Country:US
Mailing Address - Phone:510-488-6767
Mailing Address - Fax:510-488-6766
Practice Address - Street 1:1936 UNIVERSITY AVE STE 112
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704
Practice Address - Country:US
Practice Address - Phone:510-488-6767
Practice Address - Fax:510-488-6766
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-06-22
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Provider Licenses
StateLicense IDTaxonomies
CAA87857207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFS347AMedicare PIN