Leo Nyholm

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 11592 Issued in CA

Legal business name

LEO NYHOLM

Practice address

20825 South St
Suite D
Tehachapi, CA 93561-8649

Phone

(661) 822-1965

Fax

(661) 823-1971

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Leo Nyholm, BIOANALYST

Title

Owner

Phone

(661) 822-1965

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Lab Services Doing business as

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1164554713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20825 SOUTH ST",
            "address_2": "SUITE D",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618649",
            "telephone_number": "661-822-1965",
            "fax_number": "661-823-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20825 SOUTH ST",
            "address_2": "SUITE D",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618649",
            "telephone_number": "661-822-1965",
            "fax_number": "661-823-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO NYHOLM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "NYHOLM",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-822-1965",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BIOANALYST"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 11592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ17938Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "05D0962446",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABORATORY LICENSE NUMBER",
            "identifier": "CLF11592",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lab Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura White Chiropractic
• Kevin Pham Le, PHARMD
• Arvid Lynn Leighton, PSY.D.
• Jaimee Lynn Leiva
• Emily Grace Leland
• Robert James Leslie, P.A.
• Christopher A Lewis, PA-C
• Willy P Little Sr., PHARMACY TECH
• Harrison Liu, PHARM.D.
• Scott Long, ATC

• Clinical Medical Laboratory in Tehachapi, CA
• Providers in Tehachapi, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.