Provider Demographics
NPI:1861608002
Name:LEBLANC, GREGORY E (LAC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:E
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:520 EL CERRITO PLZ
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-4006
Mailing Address - Country:US
Mailing Address - Phone:510-275-3330
Mailing Address - Fax:510-527-5330
Practice Address - Street 1:520 EL CERRITO PLZ
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-4006
Practice Address - Country:US
Practice Address - Phone:510-275-3330
Practice Address - Fax:510-527-5330
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC5517171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist