Provider Demographics
NPI:1700147394
Name:LESH, KEVIN CASTILLO (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CASTILLO
Last Name:LESH
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 1:1263 LAKE PLAZA DR STE 230
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3512
Mailing Address - Country:US
Mailing Address - Phone:719-776-3300
Mailing Address - Fax:
Practice Address - Street 1:1263 LAKE PLAZA DR STE 230
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3512
Practice Address - Country:US
Practice Address - Phone:719-776-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0061255207Q00000X
NY284232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine