MEDICARE: DR. LESLEY C PRINCE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD224145	OR
2	208M00000X	Hospitalist Physician	A124531	CA

General Provider Information

NPI Number	:	1346569191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLEY C PRINCE MD

Provider Business Mailing Address
First Line	:	3400 DATA DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-7956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18460 ROSCOE BLVD FL 3
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-4107
Country	:	US
Telephone Number	:	818-885-5480
Fax Number	:	818-993-1917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2010
Last Update Date	:	12/03/2025

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Directions to “ DR. LESLEY C PRINCE MD” Practice Location

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