Provider Demographics
NPI:1295835072
Name:FARINAS, LEAH P (MD)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:P
Last Name:FARINAS
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 1:6699 ALVARADO RD STE 2210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5240
Mailing Address - Country:US
Mailing Address - Phone:619-522-2900
Mailing Address - Fax:619-923-4000
Practice Address - Street 1:6699 ALVARADO RD STE 2210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5240
Practice Address - Country:US
Practice Address - Phone:619-522-2900
Practice Address - Fax:619-923-4000
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88077208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A880770Medicaid
CA00A880770Medicaid
CA20-4040301OtherTIN
CAA88077Medicare ID - Type Unspecified