Provider Demographics
NPI:1588673446
Name:LEJA, CATHERINE ANNETTE (MD PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNETTE
Last Name:LEJA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 PIONEER LN STE B
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2517
Mailing Address - Country:US
Mailing Address - Phone:760-873-2849
Mailing Address - Fax:760-873-2836
Practice Address - Street 1:135-B PIONEER LANE
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514
Practice Address - Country:US
Practice Address - Phone:760-873-2849
Practice Address - Fax:760-873-2836
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73578207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A73578Medicaid
NV00A735780Medicaid
P00203881OtherRAILROAD MEDICARE
NV00A735780Medicaid