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General NPI Number Information
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NPI Number | 1942595624
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Entity Type | Individual
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Provider Name | LESLIE ANN LANE MD
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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 | 11/11/2025
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Provider Practice Location Address
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Address Line | 584 CASTRO ST STE 3070
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-2512
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Country | US
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Telephone | 888-708-0561
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Fax |
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Provider Business Mailing Address
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Address Line | 284 CHERRY AVE APT A
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City | AUBURN
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State | CA
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Zip | 95603-4844
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Country | US
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Telephone | 530-902-9331
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 124958
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License Number State | CA
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