San Juan, Rodolfo Leongson

San Juan, Rodolfo Leongson is an individual health care provider with primary practice located at 11161 Randolph St , Crown Point IN 46307-8564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. San Juan, Rodolfo Leongson can be contacted via phone (219) 662-9424.

Contact Information

Primary practice address
11161 Randolph St Crown Point IN 46307-8564
Phone: (219) 662-9424
Fax: (219) 662-7465
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0116017383 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01064429A Indiana

Profile Details

NPI number 1881895233
LBN Legal business name San Juan, Rodolfo Leongson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2007
Last updated Sep 14th, 2023 - about 2 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 1881895233 NPPES
Indiana MEDICAID 200386920

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