Healthcare Provider Details

I. General information

NPI: 1932235421
Provider Name (Legal Business Name): JOHN LESLIE CHSAE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIVISADERO ST UCSF MEDICAL CENTER
SAN FRANCISCO CA
94115-3010
US

IV. Provider business mailing address

10423 OLD PLACERVILLE RD # 100
SACRAMENTO CA
95827-2508
US

V. Phone/Fax

Practice location:
  • Phone: 415-885-7268
  • Fax: 415-885-7611
Mailing address:
  • Phone: 916-920-2272
  • Fax: 916-920-2515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA22985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: