MEDICARE: LESLIE BARRIENTOS

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	343900000X	Non-emergency Medical Transport (VAN)		CA

General Provider Information

NPI Number	:	1396208195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE BARRIENTOS

Provider Business Mailing Address
First Line	:	4214 E ADDINGTON DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-2801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1146 N CENTRAL AVE # 344
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2506
Country	:	US
Telephone Number	:	951-314-3715
Fax Number	:

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

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	04/09/2019

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Directions to “ LESLIE BARRIENTOS ” Practice Location

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