Provider Demographics
NPI:1093891897
Name:FOOTE, LESLIE ARDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ARDEN
Last Name:FOOTE
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:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902
Mailing Address - Country:US
Mailing Address - Phone:831-771-0244
Mailing Address - Fax:831-771-0243
Practice Address - Street 1:31 WINHAM ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-771-0244
Practice Address - Fax:831-771-0243
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG060560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA006605600Medicaid
CA006605600Medicaid
CA00G605603Medicare ID - Type Unspecified