MEDICARE: DR. LOREN A LESHAN M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G86992	CA
2	101YM0800X	Mental Health Counselor		CA
3	207Q00000X	Family Medicine Physician	25641	WI
4	207Q00000X	Family Medicine Physician	ME98855	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00760798	OTHER	FL	RR MEDICARE
4	K1951A	OTHER	FL	BPC MEDICARE GROUP PTAN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50655	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1194832642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOREN A LESHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9602
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91346-9602
Country	:	US
Telephone Number	:	818-837-5559
Fax Number	:	818-792-4793

Provider Business Practice Location Address
First Line	:	19950 RINALDI ST
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-4141
Country	:	US
Telephone Number	:	818-403-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/18/2025

19950 RINALDI ST STE 300
PORTER RANCH, CA
91326-4141

Practice Phone: 818-271-2400
Practice Fax: 818-271-2401