Provider Demographics
NPI:1225368004
Name:LUSK, LESLIE ARIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ARIN
Last Name:LUSK
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:505 PARNASSUS BOX 0110
Mailing Address - Street 2:UC SAN FRANCISCO, M691
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-476-6245
Mailing Address - Fax:415-276-1757
Practice Address - Street 1:505 PARNASSUS BOX 0110
Practice Address - Street 2:UC SAN FRANCISCO, M691
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0001
Practice Address - Country:US
Practice Address - Phone:415-476-6245
Practice Address - Fax:415-276-1757
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA 110156208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics