Provider Demographics
NPI:1659319689
Name:SAXON, LESLIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:SAXON
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44949207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0016910OtherGROUP MEDICAID PIN
CA1902846306OtherGROUP NPI
CA00A449490Medicaid
CA1356390009OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CAP00067731OtherRAILROAD MEDICARE
CA00A449490197OtherCAL OPTIMA
CACE1617OtherGROUP RAILROAD MEDICARE
CAW18762OtherGROUP MEDICARE
CA00A449490OtherBLUE SHIELD
CAW11675OtherGROUP MEDICARE PIN
CAP00067731OtherRAILROAD MEDICARE
CA00A449490Medicaid