Leland E Watkins M D Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G30953 Issued in CA

Legal business name

LELAND E WATKINS M D INC

Practice address

1818 Verdugo Blvd
Suite 108
Glendale, CA 91208-1403

Phone

(818) 790-1145

Fax

(818) 790-6387

NPI assigned

Oct 17, 2007

Last updated

Sep 2, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adriana Veda Shepherd

Title

Office Manager

Phone

(818) 790-1145

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1063601888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 108",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-790-1145",
            "fax_number": "818-790-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 108",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-790-1145",
            "fax_number": "818-790-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LELAND E WATKINS M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_middle_name": "VEDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-790-1145"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G30953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.