Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 20A10114 | CA |
NPI | 1164613634 |
---|---|
Provider Name | Dr. Leslee H Devies |
First Address | Penngrove, CA 94951-1247 |
Second Address | Redding, CA 96001-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 30/04/2013 |