Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Leon Koenck, PAC

Individual provider Physician Assistant · NPI 1164555769

Mr. Leon Koenck, PAC is a Physician Assistant in Gualala, California. Licensed in Alaska, California and Washington. Registered with an NPI since 2007.

Licensed in
AK, CA, WA
In the registry since
2007
Specialties on file
5
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

46900 Ocean Dr Ste 1100
Gualala, CA 95445-8353
Phone: (707) 884-4005
Fax: (707) 884-4625
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA19714 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 270 (AK)
Physician Assistant Taxonomy 363A00000X · Licence PA 10003212 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA19714 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10003212 (WA)

Record details

NPI number1164555769
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMarch 13, 2007
Last updated in NPPESFebruary 2, 2016

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