Provider Demographics
NPI:1760126395
Name:LEILA BOZORGNIA MD INC
Entity Type:Organization
Organization Name:LEILA BOZORGNIA MD INC
Other - Org Name:CALIFORNIA KIDS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZORGNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-277-2020
Mailing Address - Street 1:28431 GOLDEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-2925
Mailing Address - Country:US
Mailing Address - Phone:310-994-9659
Mailing Address - Fax:
Practice Address - Street 1:23530 HAWTHORNE BLVD STE 260
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4726
Practice Address - Country:US
Practice Address - Phone:424-322-9866
Practice Address - Fax:310-388-1104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEILA BOZORGNIA MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty