Provider Demographics
NPI:1316470560
Name:LEAF, PATRICK (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:LEAF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 WAIMEA CANYON DR
Mailing Address - Street 2:
Mailing Address - City:WAIMEA
Mailing Address - State:HI
Mailing Address - Zip Code:96796
Mailing Address - Country:US
Mailing Address - Phone:808-338-9431
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE C
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157557207P00000X
390200000X
HIMD-21002207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program