Di Leonardo, Charles

Di Leonardo, Charles is an sole proprietor health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Di Leonardo, Charles can be contacted via phone (208) 814-1000.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 814-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-2147 Idaho

Profile Details

NPI number 1356095871
LBN Legal business name Di Leonardo, Charles
Credentials MSPAS, PA-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 4th, 2022
Last updated Apr 11th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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