Provider Demographics
NPI:1114129186
Name:LESCHER, RAVI (MPT)
Entity Type:Individual
Prefix:MS
First Name:RAVI
Middle Name:
Last Name:LESCHER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:RAVI
Other - Middle Name:
Other - Last Name:SEKHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:147 LOMITA DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3034
Mailing Address - Country:US
Mailing Address - Phone:415-342-3641
Mailing Address - Fax:
Practice Address - Street 1:147 LOMITA DR
Practice Address - Street 2:SUITE A
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1451
Practice Address - Country:US
Practice Address - Phone:415-342-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27236225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT272360Medicare ID - Type Unspecified