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General NPI Number Information
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NPI Number | 1073633103
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Entity Type | Individual
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Provider Name | LESLIE HACO ALHADEFF M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 41865 BOARDWALK SUITE 204
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City | PALM DESERT
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State | CA
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Zip | 92211-9026
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Country | US
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Telephone | 760-674-0331
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Fax | 760-674-0332
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Provider Business Mailing Address
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Address Line | 41865 BOARDWALK SUITE 204
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City | PALM DESERT
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State | CA
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Zip | 92211-9026
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Country | US
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Telephone | 760-674-0331
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Fax | 760-674-0332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | G53660
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License Number State | CA
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