Provider Demographics
NPI:1225090483
Name:AOTO, LESLIE M (OT CHT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:M
Last Name:AOTO
Suffix:
Gender:F
Credentials:OT CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 EL CAMIO REAL ST
Mailing Address - Street 2:STE 190
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130
Mailing Address - Country:US
Mailing Address - Phone:858-793-1460
Mailing Address - Fax:858-793-1989
Practice Address - Street 1:12250 EL CAMIO REAL ST
Practice Address - Street 2:STE 190
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130
Practice Address - Country:US
Practice Address - Phone:858-793-1460
Practice Address - Fax:858-793-1989
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT434225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WOT434CMedicare ID - Type Unspecified
CAWOT434DMedicare PIN
CAW7125Medicare PIN
CAW7125AMedicare PIN
CAGC478ZMedicare PIN
WOT434BMedicare ID - Type Unspecified