Provider Demographics
NPI:1972571149
Name:FRANK, LESLIE ELLEN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ELLEN
Last Name:FRANK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 WAPELLO ST
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1452
Mailing Address - Country:US
Mailing Address - Phone:626-449-3900
Mailing Address - Fax:626-449-4505
Practice Address - Street 1:3018 E COLORADO BLVD
Practice Address - Street 2:#100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3840
Practice Address - Country:US
Practice Address - Phone:626-449-3900
Practice Address - Fax:626-449-4505
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27660225100000X, 2251N0400X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT276600OtherBLUE SHIELF
CAPT27660Medicare ID - Type Unspecified