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Individual

MS. LESLIE DAWN SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
161 MITCHELL BLVD STE 101, SAN RAFAEL, CA 94903-2068
(415) 507-2815
(415) 473-2353
Mailing address
535 LARKSPUR PLAZA DR APT 7, LARKSPUR, CA 94939-1474
(415) 827-0463

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11186109
KAISER
CA
Enumeration date
09/20/2006
Last updated
07/08/2007
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