Provider Demographics
NPI:1689648511
Name:ADORADOR, LEONARD A (DPT)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:A
Last Name:ADORADOR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 E 6TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-5760
Mailing Address - Country:US
Mailing Address - Phone:951-769-0300
Mailing Address - Fax:951-769-2811
Practice Address - Street 1:1676 E 6TH ST STE C
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-5760
Practice Address - Country:US
Practice Address - Phone:951-769-0300
Practice Address - Fax:951-769-2811
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24475174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA24475OtherLICENSE NUMBER
CA24475OtherLICENSE NUMBER