MEDICARE: MR. LESLIE S. JONES RPH

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	183500000X	Pharmacist	30199	CA

General Provider Information

NPI Number	:	1740400209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LESLIE S. JONES RPH

Provider Business Mailing Address
First Line	:	13525 PACIFIC BREEZE DR
Second Line	:
City	:	SANTA ROSA VALLEY
State	:	CA
Zip	:	93012-8951
Country	:	US
Telephone Number	:	805-523-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	13525 PACIFIC BREEZE DR
Second Line	:
City	:	SANTA ROSA VALLEY
State	:	CA
Zip	:	93012-8951
Country	:	US
Telephone Number	:	805-523-2002
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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