Provider Demographics
NPI:1538595616
Name:LEONARD GRAF, OD, PC
Entity type:Organization
Organization Name:LEONARD GRAF, OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-690-6510
Mailing Address - Street 1:18801 E HAMPDEN AVE STE 176
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3587
Mailing Address - Country:US
Mailing Address - Phone:303-690-6510
Mailing Address - Fax:303-690-6620
Practice Address - Street 1:18801 E HAMPDEN AVE STE 176
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3587
Practice Address - Country:US
Practice Address - Phone:303-690-6510
Practice Address - Fax:303-690-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1354261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18229Medicare UPIN