Pravoverov, Leonid

Pravoverov, Leonid is an individual health care provider with primary practice located at 7373 West Ln , Stockton CA 95210-3377. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Pravoverov, Leonid can be contacted via phone (209) 476-2000.

Contact Information

Primary practice address
7373 West Ln Stockton CA 95210-3377
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A77583 California

Profile Details

NPI number 1306924113
LBN Legal business name Pravoverov, Leonid
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Dec 8th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306924113 NPPES
California MEDICAID 00A775830

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