Provider Demographics
NPI:1942040787
Name:REDMAN, LEONARD H
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:H
Last Name:REDMAN
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 1:16320 STEVENS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-5035
Mailing Address - Country:US
Mailing Address - Phone:562-944-4669
Mailing Address - Fax:
Practice Address - Street 1:30015 ROSE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4733
Practice Address - Country:US
Practice Address - Phone:760-969-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging