Basic Information
| Provider Information | |||||||||
| NPI: | 1205941010 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OKUN | ||||||||
| FirstName: | LEONARD | ||||||||
| MiddleName: | MARK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 828 NEPTUNE AVENUE | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604364000 | ||||||||
| FaxNumber: | 7604362471 | ||||||||
| Practice Location | |||||||||
| Address1: | 5575 RUFFLIN ROAD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585651300 | ||||||||
| FaxNumber: | 8585656932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G21981 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.