Provider Demographics
NPI:1013045129
Name:TSANG, LESLIE AARON (DO)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:AARON
Last Name:TSANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 SANTA BARBARA RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2422
Mailing Address - Country:US
Mailing Address - Phone:510-725-1006
Mailing Address - Fax:
Practice Address - Street 1:900 COLUSA AVE STE 205A
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2319
Practice Address - Country:US
Practice Address - Phone:415-706-4509
Practice Address - Fax:510-295-2567
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA94112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A9411OtherOSTEOPATHIC MEDICAL LICENSE
BT9625712OtherDEA