MEDICARE: DR. LESLIE J GRIFFITH OD

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	152W00000X	Optometrist	10586	CA

General Provider Information

NPI Number	:	1700110210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE J GRIFFITH OD

Provider Business Mailing Address
First Line	:	1737 1ST ST
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-2437
Country	:	US
Telephone Number	:	707-226-5446
Fax Number	:	707-226-3772

Provider Business Practice Location Address
First Line	:	1737 1ST ST
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-2437
Country	:	US
Telephone Number	:	707-226-5446
Fax Number	:	707-226-3772

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

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	11/05/2024

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