Provider Demographics
NPI:1336178102
Name:TREYGER, LEONID (MD)
Entity Type:Individual
Prefix:
First Name:LEONID
Middle Name:
Last Name:TREYGER
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 1:200 OCEANGATE
Mailing Address - Street 2:#100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:562-499-6191
Mailing Address - Fax:877-860-2703
Practice Address - Street 1:3234 MARYSVILLE BL
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-1411
Practice Address - Country:US
Practice Address - Phone:916-646-1200
Practice Address - Fax:877-860-2703
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01222614/ DS9933OtherRAILROAD MEDICARE-CITRUS HEIGHTS, MACK RD
CAP01465686 - DV5277OtherRR MEDICARE - CITRUS HEIGHTS, MACK RD, MARYSVILLE, 55TH ST & NORWOOD LOCATIONS
CA00A649300Medicaid
CA00A649302Medicare PIN
CAAY713YMedicare PIN
CAP01222614/ DS9933OtherRAILROAD MEDICARE-CITRUS HEIGHTS, MACK RD
H00348Medicare UPIN
CACA141018Medicare PIN
CA00A649303Medicare PIN
CAAY713XMedicare PIN
CAAY713ZMedicare PIN
CAAY713VMedicare PIN
CAP01465686 - DV5277OtherRR MEDICARE - CITRUS HEIGHTS, MACK RD, MARYSVILLE, 55TH ST & NORWOOD LOCATIONS
CA00A649304Medicare PIN
CA00A649300Medicare PIN