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Contact Information

CHARLES DI LEONARDO, MSPAS, PA-C
1690 E AMARGOSA FARM RD
AMARGOSA VALLEY, NV89020-9735
 Phone: 775-372-5432
 Fax: 775-372-1303
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CHARLES DI LEONARDO · (Male)

NPI # 1356095871
Status Active
Credentials MSPAS, PA-C
Entity Individual
Enumeration date 02/04/2022
Last updated 11/20/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • NV License # PA-3033
  • NV Medicaid 250017702
Hospital affiliation(s)
  • ST LUKES REGIONAL MEDICAL CENTER - (Acute Care)
    190 EAST BANNOCK STREET
    BOISE, ID 83712
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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