Provider Demographics
NPI:1720009095
Name:NGUYEN, LEIGH ECHOLS (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ECHOLS
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5971 VENICE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1713
Mailing Address - Country:US
Mailing Address - Phone:323-857-2000
Mailing Address - Fax:
Practice Address - Street 1:5971 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1713
Practice Address - Country:US
Practice Address - Phone:323-857-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1266207R00000X, 208M00000X
CAC185788207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00281858OtherRR MEDICARE
TX173890801Medicaid
TX8R1956OtherBCBS
TX173890802Medicaid
TX173890802Medicaid
TXP01090806Medicare PIN
TXP00281858OtherRR MEDICARE
TX8D5644Medicare PIN