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General NPI Number Information
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NPI Number | 1700812963
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Entity Type | Individual
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Provider Name | LESLEY L. PO MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 130 W ROUTE 66
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City | GLENDORA
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State | CA
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Zip | 91740-6249
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Country | US
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Telephone | 626-335-4079
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Fax | 626-335-5507
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Provider Business Mailing Address
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Address Line | 130 W ROUTE 66 STE 208
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City | GLENDORA
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State | CA
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Zip | 91740-6251
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Country | US
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Telephone | 626-335-4079
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Fax | 626-335-5507
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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 | A70911
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License Number State | CA
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