Provider Demographics
NPI:1538387246
Name:CUMMINS, LEO HERBERT (MD)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:HERBERT
Last Name:CUMMINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9 EMERALD BAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1206
Mailing Address - Country:US
Mailing Address - Phone:949-494-7827
Mailing Address - Fax:949-715-3015
Practice Address - Street 1:9 EMERALD BAY
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1206
Practice Address - Country:US
Practice Address - Phone:949-494-7827
Practice Address - Fax:949-715-3015
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC0330821207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy