Provider Demographics
NPI:1912925074
Name:LANGLOIS, LEO PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:PETER
Last Name:LANGLOIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22710
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2710
Mailing Address - Country:US
Mailing Address - Phone:661-900-4856
Mailing Address - Fax:661-326-8037
Practice Address - Street 1:230 S. MONTCLAIR ST STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-326-8035
Practice Address - Fax:661-326-8037
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG860152081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56-2375861OtherTAX ID
CAH45118Medicare UPIN
CA00G860151Medicare ID - Type Unspecified