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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. LEON KOENCK, PA C

Active

MR. LEON KOENCK, PA C is a Physician Assistant healthcare provider located in GUALALA, California. NPI 1164555769 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · GUALALA, CA

Registration Details

NPI Number
1164555769
Provider Type
Individual
Gender
Male
NPI Issued
Mar 13, 2007 (19.398560652707 yrs)
Last Updated
Feb 2, 2016
Licenses
270 (AK)
PA19714 (CA)
PA 10003212 (WA)
PA19714 (CA)
PA10003212 (WA)

Practice Information

Address
46900 OCEAN DR
STE 1100
GUALALA, CA, 954458353
Browse CA providers · Browse ZIP 95445
Phone
7078844005
Fax
7078844625
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant
Additional Specialty
Physician Assistant
Additional Specialty
Medical Physician Assistant
Additional Specialty
Medical Physician Assistant

Other Physician Assistant Providers in GUALALA, CA

Name Credential NPI
LAUNDON TRANSUE 1316644917
STEPHANIE HSIEH 1720868045
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.