Provider Demographics
NPI:1578532735
Name:LEONI, MICHAEL KELLY (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KELLY
Last Name:LEONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93246
Mailing Address - Country:US
Mailing Address - Phone:559-998-0232
Mailing Address - Fax:
Practice Address - Street 1:937 FRANKLIN AVENUE
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93246
Practice Address - Country:US
Practice Address - Phone:559-998-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61960207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine