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General NPI Number Information
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NPI Number | 1942728050
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Entity Type | Individual
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Provider Name | JOSHUA LEAZENBY PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 09/08/2017
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Provider Practice Location Address
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Address Line | 2400 BAHAMAS DR STE 200
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0747
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Country | US
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Telephone | 661-328-5565
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Fax |
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Provider Business Mailing Address
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Address Line | 335 N 500 E
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City | SALEM
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State | UT
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Zip | 84653-9408
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Country | US
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Telephone | 714-389-8662
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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