Provider Demographics
NPI:1417170523
Name:NATHAN, LEENA SHANKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEENA
Middle Name:SHANKAR
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1250 LA VENTA DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3702
Mailing Address - Country:US
Mailing Address - Phone:805-557-7180
Mailing Address - Fax:805-557-7181
Practice Address - Street 1:1250 LA VENTA DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3702
Practice Address - Country:US
Practice Address - Phone:805-557-7180
Practice Address - Fax:805-557-7181
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94923207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology