Healthcare Provider Details

I. General information

NPI: 1467680694
Provider Name (Legal Business Name): LEAH GILANA GESSIN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH GILANA KIRSCH PA

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 CAPITOL AVE
SACRAMENTO CA
95816-6006
US

IV. Provider business mailing address

P.O. BOX 255228
SACRAMENTO CA
95816-6006
US

V. Phone/Fax

Practice location:
  • Phone: 916-262-9440
  • Fax: 916-262-9445
Mailing address:
  • Phone: 800-470-0071
  • Fax: 916-437-0578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA20355
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA20355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: