Provider Demographics
NPI:1114563731
Name:PASTERNACK, LESLIE A (DAOM, OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:PASTERNACK
Suffix:
Gender:F
Credentials:DAOM, OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9113 LUNAR TOPAZ CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4650
Mailing Address - Country:US
Mailing Address - Phone:858-248-7885
Mailing Address - Fax:
Practice Address - Street 1:INTEGRATED ACUPUNCTURE OF SOUTHERN NEVADA
Practice Address - Street 2:7250 PEAK DR #106
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-763-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist