Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 134762 | CA |
N | 208600000X | Surgeon | 134762 | CA |
N | 208200000X | Surgeon | D74206 | MD |
N | 208600000X | Surgeon | D74206 | MD |
Y | 2086S0102X | Surgical Critical Care | 134762 | CA |
N | 2086S0102X | Surgical Critical Care | CS00221453 | NM |
N | 2086S0102X | Surgical Critical Care | D74206 | MD |
N | 2086S0102X | Surgical Critical Care | MD2015-0146 | NM |
N | 2086S0127X | Trauma Surgeon | 134762 | CA |
N | 2086S0127X | Trauma Surgeon | D74206 | MD |
NPI | 1356546774 |
---|---|
Provider Name | Dr. Leigh Ann Slater |
First Address | Santa Rosa, CA 95403-7421 |
Second Address | Santa Rosa, CA 95405-4897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2007 |
Last Update Date | 22/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055296800 | (05) | MD |