Provider Demographics
NPI:1982652905
Name:ROSENBLUM, LELAND H (MD)
Entity Type:Individual
Prefix:
First Name:LELAND
Middle Name:H
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 UPPER RAGSDALE DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-372-1500
Mailing Address - Fax:831-655-6493
Practice Address - Street 1:21 UPPER RAGSDALE DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-372-1500
Practice Address - Fax:831-655-6493
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72002207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G720020Medicare ID - Type Unspecified