Provider Demographics
NPI:1295480895
Name:STURGIS, LEONARD JOSEPH
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:JOSEPH
Last Name:STURGIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SANTA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-6854
Mailing Address - Country:US
Mailing Address - Phone:717-476-7648
Mailing Address - Fax:
Practice Address - Street 1:118 SANTA ROSA DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-6854
Practice Address - Country:US
Practice Address - Phone:717-476-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program