Provider Demographics
NPI:1457436990
Name:LESTER, JEFF (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:LESTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ASPEN WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-6054
Mailing Address - Country:US
Mailing Address - Phone:831-724-1164
Mailing Address - Fax:831-724-1252
Practice Address - Street 1:65 ASPEN WAY STE 1
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-6054
Practice Address - Country:US
Practice Address - Phone:831-724-1164
Practice Address - Fax:831-724-1252
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEO8912Medicare UPIN
CA020A54210Medicare ID - Type Unspecified