Hardy, Tyrone Leslie

Hardy, Tyrone Leslie is an individual health care provider with primary practice located at 5565 Grossmont Center Dr Bldg. 1, Suite 119, La Mesa CA 91942-3020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Hardy, Tyrone Leslie can be contacted via phone (619) 464-3153.

Contact Information

Primary practice address
5565 Grossmont Center Dr Bldg. 1, Suite 119 La Mesa CA 91942-3020
Phone: (619) 464-3153
Fax: (619) 464-3429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X G57014 California

Profile Details

NPI number 1174739460
LBN Legal business name Hardy, Tyrone Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2007
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1174739460 NPPES
California Other ZZZ56955Z BLUE SHIELD
California MEDICAID 00G570140 BLUE SHIELD
California Other 1962574715 BLUE SHIELD

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