Provider Demographics
NPI:1922325976
Name:RONALD S. LEUCHTER MD INC
Entity Type:Organization
Organization Name:RONALD S. LEUCHTER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEUCHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-652-3779
Mailing Address - Street 1:PO BOX 3736
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-0736
Mailing Address - Country:US
Mailing Address - Phone:310-652-3779
Mailing Address - Fax:310-659-9039
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:#AC1111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-0750
Practice Address - Country:US
Practice Address - Phone:310-652-3779
Practice Address - Fax:310-659-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26569207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26569Medicare PIN