Basic Information
| Provider Information | |||||||||
| NPI: | 1821078692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CEDARS | ||||||||
| FirstName: | LEONARD | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 CASA ST | ||||||||
| Address2: | SUITE D-3 | ||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934051883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055462057 | ||||||||
| FaxNumber: | 8057840895 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 CASA ST | ||||||||
| Address2: | SUITE D-3 | ||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934051883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055462057 | ||||||||
| FaxNumber: | 8057840895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | G76782 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1295741668 | 01 | TYPE 1 NPI | OTHER | 1639159411 | 01 | TYPE 2 NPI | OTHER |