Provider Demographics
NPI:1871391409
Name:GARCIA, LEONEL GARCIA (LDO)
Entity type:Individual
Prefix:
First Name:LEONEL GARCIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 N SCOTTSDALE RD STE 176
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-3662
Mailing Address - Country:US
Mailing Address - Phone:480-306-8803
Mailing Address - Fax:
Practice Address - Street 1:7001 N SCOTTSDALE RD STE 176
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-3662
Practice Address - Country:US
Practice Address - Phone:480-306-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLDO002423156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician