MEDICARE: DR. TONIA MARIE LESSANI 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	20A6777	CA
2	208M00000X	Hospitalist Physician	20A6777	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20A6777	OTHER	CA	PRIVATE INSURANCE

General Provider Information

NPI Number	:	1356337075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONIA MARIE LESSANI MD

Provider Business Mailing Address
First Line	:	1501 TROUSDALE DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-726-2217
Fax Number	:	650-712-1523

Provider Business Practice Location Address
First Line	:	1501 TROUSDALE DR
Second Line	:	MILLS PENINSULA HOSPITAL
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-696-5400
Fax Number	:

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	11/07/2011

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