Provider Demographics
NPI:1962655779
Name:LESKIW, WENDY IRENE (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:IRENE
Last Name:LESKIW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1704
Mailing Address - Country:US
Mailing Address - Phone:213-383-1300
Mailing Address - Fax:
Practice Address - Street 1:3303 WILSHIRE BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1704
Practice Address - Country:US
Practice Address - Phone:213-383-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53808174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist