Provider Demographics
NPI:1730648551
Name:LEAL, CHRISTIAN ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ALBERTO
Last Name:LEAL
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 1:1365B CLIFTON RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-2020
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE BLDG B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-5014
Practice Address - Country:US
Practice Address - Phone:817-807-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPENDING207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology