Individual
LESLIE M POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(188) 853-9878
Mailing address
3900 W COAST HWY, SUITE 310, NEWPORT BEACH, CA 92663-4091
(949) 478-8858
(949) 242-2465
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95005257
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
95005257
CA
363LG0600X
Gerontology Nurse Practitioner
95005257
CA
363LP0200X
Pediatric Nurse Practitioner
95005257
CA
Other
Enumeration date
12/12/2006
Last updated
05/13/2020
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