Provider Demographics
NPI:1205936861
Name:LEONI, JAMES FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANCIS
Last Name:LEONI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3536 MENDOCINO AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3634
Mailing Address - Country:US
Mailing Address - Phone:707-525-6485
Mailing Address - Fax:707-782-9622
Practice Address - Street 1:104 LYNCH CREEK WAY
Practice Address - Street 2:STE 10
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2355
Practice Address - Country:US
Practice Address - Phone:707-782-9123
Practice Address - Fax:707-782-9622
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2012-02-08
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Provider Licenses
StateLicense IDTaxonomies
CAG56154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G561540OtherBS OF CALIFORNIA
P00469225OtherRR MEDICARE
CA1205936861Medicaid
CA00G561540Medicare PIN
CA00G561541Medicare PIN
CAF24895Medicare UPIN