Doctor Name: | MR. ROBERT JAMES LESLIE |
NPI Number: | 1043402787 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | 16379 |
Business Practice Address: | 24900 Highway 202 Tehachapi, CA - 93561 |
Business Phone Number: | 6618224402 |
Business Fax Number: | 6618235004 |
Mailing Address: | 24900 Highway 202, TEHACHAPI |
State: | CA |
Postal Code: | 93561 |
Phone Number: | 6618224402 |
Fax Number: | 6618235004 |
NPI Enumeration Date: | 08/16/2007 |
NPI Last Update Date: | 03/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 16379 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |