Provider Demographics
NPI:1649231309
Name:LEKA, TESFAYE WOLDE (MD)
Entity Type:Individual
Prefix:DR
First Name:TESFAYE
Middle Name:WOLDE
Last Name:LEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14792 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-2658
Mailing Address - Country:US
Mailing Address - Phone:562-988-7000
Mailing Address - Fax:562-988-7335
Practice Address - Street 1:2600 REDONDO AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2329
Practice Address - Country:US
Practice Address - Phone:562-988-7000
Practice Address - Fax:562-988-7335
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG075485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine