Individual
ANNE MARIA LEISTIKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2323
(619) 232-1360
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2323
(619) 232-1360
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
24079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W5352
UPIN
CA
Enumeration date
03/13/2009
Last updated
03/13/2009
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