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NPI Code Detail

MEDICARE: MRS. LESLIE WHITNEY PA-C

MEDICARE:  MRS. LESLIE  WHITNEY  PA-C
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
1363A00000XPhysician Assistant17159CA

General Provider Information

NPI Number : 1508163593
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LESLIE WHITNEY PA-C
Provider Business Mailing Address
First Line : PO BOX 53366
Second Line :
City : IRVINE
State : CA
Zip : 92619-3366
Country : US
Telephone Number : 949-612-9090
Fax Number : 949-612-9091
Provider Business Practice Location Address
First Line : 113 WATERWORKS WAY STE 155
Second Line :
City : IRVINE
State : CA
Zip : 92618-3163
Country : US
Telephone Number : 949-612-9090
Fax Number : 949-612-9091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2011
Last Update Date : 04/04/2018

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Directions to “ MRS. LESLIE WHITNEY PA-C” Practice Location

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