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General NPI Number Information
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NPI Number | 1124694807
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Entity Type | Individual
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Provider Name | LEILA STEPHANE JOSEPH DO
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Gender | Female
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 801 E MOUNTAIN VIEW ST
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City | BARSTOW
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State | CA
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Zip | 92311-3053
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Country | US
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Telephone | 347-893-2164
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Fax |
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Provider Business Mailing Address
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Address Line | 11454 NAUTICAL LN APT 12
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City | HELENDALE
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State | CA
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Zip | 92342-7906
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT020857
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS023150
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A23591
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License Number State | CA
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