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General NPI Number Information
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NPI Number | 1609925247
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Entity Type | Organization
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Legal Business Name | LESLIE FARBER,MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7575 W WASHINGTON AVE SUITE 127
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City | LAS VEGAS
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State | NV
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Zip | 89128-4333
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Country | US
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Telephone | 310-402-7484
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33704
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City | LAS VEGAS
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State | NV
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Zip | 89133-3704
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Country | US
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Telephone | 310-402-7484
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Fax |
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Authorized Official
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Title or Position | CEO,PHYSICIAN
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Name | LESLIE FARBER
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Credential | M.D.
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Telephone | 310-402-7484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A38649
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License Number State | CA
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