Provider Demographics
NPI:1831139385
Name:CHUCK, LEONARD HS (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:HS
Last Name:CHUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9017
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-0917
Mailing Address - Country:US
Mailing Address - Phone:925-952-2888
Mailing Address - Fax:925-952-2845
Practice Address - Street 1:1505 SAINT ALPHONSUS WAY
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1570
Practice Address - Country:US
Practice Address - Phone:925-952-2888
Practice Address - Fax:925-952-2845
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG54176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G541760Medicaid
CA00G541760Medicare ID - Type Unspecified
CAA52669Medicare UPIN