Mallory Leon, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8690 Issued in ND

Practice address

25085 Pacific Crest Street
Corona, CA 92883

Phone

(951) 277-5320

NPI assigned

Nov 9, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285615864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25085 PACIFIC CREST ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833116",
            "telephone_number": "951-277-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25085 PACIFIC CREST STREET",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92883",
            "telephone_number": "951-277-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "MALLORY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "8690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11640",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lemus
• Selina Divine Leon-Segovia
• Alyssa Leon
• Darlene Leon
• Elizabeth Leon
• Maria Leon
• Stephen Orlando Leon
• Elizabeth Ann Leonard
• Jasmine Kimgoke Leong, M.D.
• Jennifer Lepore

• Family Medicine Physician in Corona, CA
• Providers in Corona, 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 Jul 8, 2007; 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.