Provider Demographics
NPI:1033276696
Name:FRANCK, LEELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEELIA
Middle Name:
Last Name:FRANCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-9121
Mailing Address - Country:US
Mailing Address - Phone:508-340-6475
Mailing Address - Fax:
Practice Address - Street 1:850 FRONT ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95061-2001
Practice Address - Country:US
Practice Address - Phone:508-340-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2156369Medicaid
MA2156369Medicaid