MEDICARE: DR. JEFF LESTER D.O.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A5421	CA

General Provider Information

NPI Number	:	1457436990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF LESTER D.O.

Provider Business Mailing Address
First Line	:	65 ASPEN WAY STE 1
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-6054
Country	:	US
Telephone Number	:	831-724-1164
Fax Number	:	831-724-1252

Provider Business Practice Location Address
First Line	:	65 ASPEN WAY STE 1
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-6054
Country	:	US
Telephone Number	:	831-724-1164
Fax Number	:	831-724-1252

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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