Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 28705 | CA |
NPI | 1043582505 |
---|---|
Provider Name | Leslie Stein |
First Address | San Diego, CA 92105-5606 |
Second Address | San Diego, CA 92105-5606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2012 |
Last Update Date | 30/01/2012 |