Provider Demographics
NPI:1275643645
Name:PELINKA, LESLIE RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:RAE
Last Name:PELINKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3377 RIVERBEND DRIVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3568
Mailing Address - Country:US
Mailing Address - Phone:541-222-8500
Mailing Address - Fax:541-222-6435
Practice Address - Street 1:3377 RIVERBEND DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8803
Practice Address - Country:US
Practice Address - Phone:541-222-8500
Practice Address - Fax:541-222-6435
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83842208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR274316Medicaid
CA00A838420Medicaid
OR137645Medicare PIN
CAI09124Medicare UPIN
OR274316Medicaid