Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A69823 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A69823 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DR.0052074 | CO |
NPI | 1396753943 |
---|---|
Provider Name | Dr. Leslie J Mclean |
First Address | Colorado Springs, CO 80909-7200 |
Second Address | Colorado Springs, CO 80909-7200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A698230 | (05) | CA |
57430071 | (05) | CO |
BM6738023 | DEA (01) | CA |
H39005 | (02) | |
P00770106 | RAILROAD MEDICARE (01) | CA |