Leonid Alex Pugach, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

18605 Issued in CA

Practice address

2970 Hilltop Mall Rd
Suite 200
Richmond, CA 94806-1947

Phone

(510) 724-4586

Fax

(510) 724-9247

NPI assigned

Nov 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1578830253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 DELLWOOD CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131841",
            "telephone_number": "510-724-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 HILLTOP MALL RD",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948061947",
            "telephone_number": "510-724-4586",
            "fax_number": "510-724-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGACH",
        "first_name": "LEONID",
        "middle_name": "ALEX",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "18605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annabell Ross Potvin, N/A
• Xavier Alexander Powell, CMT
• Lauen Winter Presley, B.A
• Procare Transport
• Angelica Pruyn, LCSW 27874
• Michelle Purvey, PSY.D.
• Hera Qayyum
• Sami Qreini
• Timothy P. Quinn, MD
• R & R Educational Homes

• Surgical Physician Assistant in Richmond, CA
• Providers in Richmond, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.