Provider Demographics
NPI:1801121744
Name:LELAND E HILBURG, MD, INC.
Entity type:Organization
Organization Name:LELAND E HILBURG, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LELAND
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HILBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-996-1886
Mailing Address - Street 1:5620 WILBUR AVE
Mailing Address - Street 2:SUITE 322
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1351
Mailing Address - Country:US
Mailing Address - Phone:818-996-1886
Mailing Address - Fax:818-344-7390
Practice Address - Street 1:5620 WILBUR AVE
Practice Address - Street 2:SUITE 322
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1351
Practice Address - Country:US
Practice Address - Phone:818-996-1886
Practice Address - Fax:818-344-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG3725208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty