Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 5763 | NV |
NPI | 1023052529 |
---|---|
Provider Name | Leslie L Zak |
First Address | Las Vegas, NV 89128-0435 |
Second Address | Las Vegas, NV 89128-0435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 22/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2002292 | (05) | NV |
88-0246826 | TAX IDENTIFICATION (01) | NV |
BZ1706071 | DEA (01) | NV |
E34671 | (02) | NV |