Basic Information
| Provider Information | |||||||||
| NPI: | 1407804750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PASCAL | ||||||||
| FirstName: | LEROY | ||||||||
| MiddleName: | B. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11722 WILMINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900592543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232492000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15248 11TH ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | VICTORVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923953704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602458691 | ||||||||
| FaxNumber: | 7608436020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 02/23/2009 | ||||||||
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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 | 207P00000X | G76597 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.