Provider Demographics
NPI:1639331333
Name:LESLEE B. COCHRANE, MD. A PROF. MED. CORP.
Entity Type:Organization
Organization Name:LESLEE B. COCHRANE, MD. A PROF. MED. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEE
Authorized Official - Middle Name:BERT
Authorized Official - Last Name:COCHRANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-698-4084
Mailing Address - Street 1:38224 OAK BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9347
Mailing Address - Country:US
Mailing Address - Phone:951-698-4084
Mailing Address - Fax:951-848-0849
Practice Address - Street 1:38224 OAK BLUFF LN
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9347
Practice Address - Country:US
Practice Address - Phone:951-698-4084
Practice Address - Fax:951-848-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty