Provider Demographics
NPI:1417973421
Name:LESCH, HARRY B (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:B
Last Name:LESCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 H ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4408
Mailing Address - Country:US
Mailing Address - Phone:707-442-1111
Mailing Address - Fax:707-442-1155
Practice Address - Street 1:2934 H ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4408
Practice Address - Country:US
Practice Address - Phone:707-442-1111
Practice Address - Fax:707-442-1155
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG222752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
104804100OtherACS OWCP FED WORKERS COMP
A41531Medicare UPIN
104804100OtherACS OWCP FED WORKERS COMP