Provider Demographics
NPI:1235227489
Name:TAYLOR, LESLIE MICHELLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1945 N FINE AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1528
Mailing Address - Country:US
Mailing Address - Phone:559-457-5231
Mailing Address - Fax:559-457-5896
Practice Address - Street 1:302 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3600
Practice Address - Country:US
Practice Address - Phone:559-457-5700
Practice Address - Fax:559-457-5790
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA67224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH24017Medicare UPIN