Provider Demographics
NPI:1023052529
Name:ZAK, LESLIE L (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:L
Last Name:ZAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2851 N TENAYA WAY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0435
Mailing Address - Country:US
Mailing Address - Phone:702-228-0319
Mailing Address - Fax:702-228-0380
Practice Address - Street 1:2851 N TENAYA WAY
Practice Address - Street 2:SUITE 208
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0435
Practice Address - Country:US
Practice Address - Phone:702-228-0319
Practice Address - Fax:702-477-0254
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV5763207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002292Medicaid
NV88-0246826OtherTAX IDENTIFICATION
NVBZ1706071OtherDEA
NV2002292Medicaid
NVBZ1706071OtherDEA