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General NPI Number Information
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NPI Number | 1841810561
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Entity Type | Individual
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Provider Name | LESLIE CRUZ DPT
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Gender | Female
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 2525 CAMINO DEL RIO S STE 220
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City | SAN DIEGO
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State | CA
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Zip | 92108-3719
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Country | US
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Telephone | 619-299-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 MANCHESTER AVE APT C
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City | CARDIFF BY THE SEA
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State | CA
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Zip | 92007-1834
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Country | US
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Telephone | 732-406-4811
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 38369
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License Number State | CA
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