Basic Information
| Provider Information | |||||||||
| NPI: | 1316961436 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEANO | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | BENEDICT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3690 S PARK AVE | ||||||||
| Address2: | SUITE 805 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857135069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206166760 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3690 S PARK AVE | ||||||||
| Address2: | SUITE 805 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857135069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206166760 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 01/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35517 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | M7360 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.