Provider Demographics
NPI:1528234226
Name:NORMAN LEAF A MEDICAL CORPERATION
Entity type:Organization
Organization Name:NORMAN LEAF A MEDICAL CORPERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-274-8001
Mailing Address - Street 1:436 N. BEDFORD DRIVE
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4323
Mailing Address - Country:US
Mailing Address - Phone:310-274-8001
Mailing Address - Fax:310-274-2337
Practice Address - Street 1:436 N. BEDFORD DRIVE
Practice Address - Street 2:SUITE #103
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4323
Practice Address - Country:US
Practice Address - Phone:310-274-8001
Practice Address - Fax:310-274-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG201742086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty