Provider Demographics
NPI:1831576248
Name:LEENA BADHWAR MD INC
Entity type:Organization
Organization Name:LEENA BADHWAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADHWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-705-7773
Mailing Address - Street 1:240 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-4452
Mailing Address - Country:US
Mailing Address - Phone:408-358-8958
Mailing Address - Fax:408-884-8012
Practice Address - Street 1:240 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4452
Practice Address - Country:US
Practice Address - Phone:408-358-8958
Practice Address - Fax:408-884-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty