Doctor profile · Federal record
Dr. Leon Koenck, PA C
Physician Assistant · Physician Assistant · Physician Assistant · Medical Physician Assistant · Medical Physician Assistant · Gualala, CA
- NPI 1164555769
- MIPS 72.1 / 100 · 2023
- 19 yrs on file
- Licensed in 3 states
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
46900 Ocean Dr, Ste 1100
Gualala, CA 954458353
(707) 884-4005
fax (707) 884-4625 - Mailing address
-
200 West 34Th Avenue, #539
Anchorage, AK 99503
Credentials & registration
- NPI registered
- March 2007 — 19 yrs on file
- Profile last updated
- February 2, 2016
- Specialty taxonomy
- 363A00000X — NUCC code
- State licenses (4)
- California #PA19714 · Alaska #270 · Washington #PA 10003212 · Washington #PA10003212
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1164555769. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$18
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Indivior INC. | 1 | $18.18 |
By nature of payment
Frequently asked questions
What is Dr. Leon Koenck's medical specialty?
Dr. Leon Koenck practices Physician Assistant in Gualala, CA.
Where does Dr. Leon Koenck practice?
Dr. Leon Koenck practices at 46900 Ocean Dr, Gualala, CA 954458353. Office phone: 7078844005.
What is Dr. Leon Koenck's NPI?
Dr. Leon Koenck's National Provider Identifier (NPI) is 1164555769, issued by NPPES.