Organization
LESLIE A BAIN MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE BAIN MD (PHYSICIAN)
(949) 720-9170
Entity
Organization
Contact information
Practice address
1441 AVOCADO AVE, SUITE 706, NEWPORT BEACH, CA 92660-7721
(949) 720-9170
(949) 720-0755
Mailing address
1441 AVOCADO AVE, SUITE 706, NEWPORT BEACH, CA 92660-7721
(949) 720-9170
(949) 720-0755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A24274
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A24274A
MEDICARE ID
—
Enumeration date
09/20/2010
Last updated
09/20/2010
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