Provider Demographics
NPI:1255374443
Name:OWENS, LEON JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:JOSEPH
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901RIVER OAK WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5548
Mailing Address - Country:US
Mailing Address - Phone:916-483-4748
Mailing Address - Fax:916-481-4060
Practice Address - Street 1:6501 COYLE AVE.
Practice Address - Street 2:MERCY SAN JUAN MEDICAL CENTER
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0306
Practice Address - Country:US
Practice Address - Phone:916-864-5692
Practice Address - Fax:916-864-5693
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG381012086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Not Answered2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23948Medicare UPIN
CA00G38101Medicare ID - Type Unspecified