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Gary A Leopold

Anesthesiology

Allopathic & Osteopathic Physicians

3315 Watt Ave, Sacramento, CA 95821-3600

PECOS Enrollment

This provider is enrolled in PECOS as GARY LEOPOLD.

Based on the most recent information from CMS, provider Gary A Leopold is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:56 AM.

Profile Details

Provider ID
1295735520
Provider Type
Individual
Full Name
Leopold, Gary A
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
7/28/2005
Last Updated
7/8/2007

Contact Information

Practice Location

3315 Watt Ave, Sacramento, CA 95821-3600

(916) 481-6800

(916) 481-1882

Mailing Location

PO Box 660970, Sacramento, CA 95866-0970

(916) 481-6800

(916) 481-1881

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License G55258 California

Provider Identifiers

ID	Description	Issuer
ID YYY20507Y	Description Medicaid	Issuer Unlisted California

Gary A Leopold

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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