Provider Demographics
NPI:1386184919
Name:MALEKSALEHI, LEADA (DPT)
Entity Type:Individual
Prefix:
First Name:LEADA
Middle Name:
Last Name:MALEKSALEHI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 12TH ST APT 310
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-3667
Mailing Address - Country:US
Mailing Address - Phone:408-857-2591
Mailing Address - Fax:
Practice Address - Street 1:3019 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3314
Practice Address - Country:US
Practice Address - Phone:408-387-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist