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General NPI Number Information
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NPI Number | 1801181581
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Entity Type | Individual
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Provider Name | LINDA-MICHELLE LEDESMA D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 11/11/2014
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Provider Practice Location Address
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Address Line | 3328 N LITCHFIELD RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-3198
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Country | US
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Telephone | 623-239-0394
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Fax | 623-536-5813
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Provider Business Mailing Address
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Address Line | 1250 S CLEARVIEW AVE SUITE 100
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City | MESA
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State | AZ
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Zip | 85209-3378
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Country | US
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Telephone | 480-988-9108
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Fax | 480-813-4460
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 006241
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License Number State | AZ
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