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DR. LEONARD PETER HOLMGREN MD

Diagnostic Radiology >> Radiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1114906088

Individual Registrant:
DR. LEONARD PETER HOLMGREN MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2170 SOUTH AVE  S LAKE TAHOE, CA 96150-7026 US
Tel: 530-543-5850  Fax: 530-542-9550

Contact information for business:
PO BOX 19879  RENO, NV 89511-2533 US
Tel: 888-480-6640  Fax: 775-852-6902

Registration Information:
NPI: 1114906088
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2085R0202XAllopathic & Osteopathic Physicians
Radiology
Diagnostic Radiology
NV9846
Y2085R0202XAllopathic & Osteopathic Physicians
Radiology
CAG86132

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1114906088NV05
RAILROAD MEDICARE300127929CA01
RAILROAD MEDICARE300127927NV01
1114906088CA05




HEALTH CARE JOBS CA - Page 1



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