Provider Demographics
NPI:1902022635
Name:SANSING, LEONARD GERALD
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:GERALD
Last Name:SANSING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JERRY
Other - Middle Name:
Other - Last Name:SANSING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 2683
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-2683
Mailing Address - Country:US
Mailing Address - Phone:916-990-0450
Mailing Address - Fax:916-450-0452
Practice Address - Street 1:1314 FULTON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3604
Practice Address - Country:US
Practice Address - Phone:916-483-3486
Practice Address - Fax:916-483-9723
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313791835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAHCS072465OtherNPI USER ID ONLY