Healthcare Provider Details

I. General information

NPI: 1346843653
Provider Name (Legal Business Name): LESLIE RANGEL GONZALEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LESLIE RANGEL DNP, APRN, FNP-BC

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 E PALOMAR ST
CHULA VISTA CA
91911-6974
US

IV. Provider business mailing address

645 E PALOMAR ST
CHULA VISTA CA
91911-6974
US

V. Phone/Fax

Practice location:
  • Phone: 619-421-6500
  • Fax: 619-421-4771
Mailing address:
  • Phone: 619-421-6500
  • Fax: 619-421-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number95015138
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: