Leila Bolandgray, M.D. Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A72176 Issued in CA

Legal business name

LEILA BOLANDGRAY, M.D. INC.

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Phone

(619) 937-6349

Fax

(866) 313-8916

NPI assigned

Jan 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Leila Sofia Bolandgray, M.D.NPI 1093931727

Title

President

Phone

(619) 937-6349

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leila Sofia Bolandgray, M.D.

  • Internal Medicine Physician
  • La Mesa, CA
  • NPI 1093931727
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1619154689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2775",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919432775",
            "telephone_number": "619-937-6349",
            "fax_number": "866-313-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-937-6349",
            "fax_number": "866-313-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEILA BOLANDGRAY, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "BOLANDGRAY",
        "authorized_official_first_name": "LEILA",
        "authorized_official_middle_name": "SOFIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-937-6349",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Legerton
• David William Lehman, M.D.
• Emily Lehn, RD
• Paula Leibham, NP
• Armando Leija, IDC
• Daniel T. Leininger, D.O.
• Krista Leirmoe, LPC
• Betty Marie Lemos, MFT
• Eugene Lenard, D.O.
• Leo Tanaka MD Inc

• Internal Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.