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General NPI Number Information
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NPI Number | 1275157919
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Entity Type | Individual
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Provider Name | LESLIE ZIONTZ
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Gender | Female
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 5733 LAS VIRGENES RD STE A
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City | CALABASAS
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State | CA
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Zip | 91302-1267
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Country | US
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Telephone | 818-456-4274
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Fax | 818-456-4273
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Provider Business Mailing Address
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Address Line | 212 ALTA AVE
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City | SANTA MONICA
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State | CA
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Zip | 90402-2728
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Country | US
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Telephone | 310-600-5017
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 48187
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License Number State | CA
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