Provider Demographics
NPI:1740816552
Name:LEGGETT, DREW (PA-C)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:LEGGETT
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 SKYWAY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1830
Mailing Address - Country:US
Mailing Address - Phone:805-922-8282
Mailing Address - Fax:805-925-2690
Practice Address - Street 1:3070 SKYWAY DR STE 106
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1830
Practice Address - Country:US
Practice Address - Phone:805-922-8282
Practice Address - Fax:805-925-2690
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57822363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant