Individual
LAURA L. LEISTIKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2975 SYCAMORE DR, EMERGENCY DEPARTMENT, SIMI VALLEY, CA 93065-1201
(805) 955-6000
Mailing address
PO BOX 662154, ARCADIA, CA 91066-2154
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A90865
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A908650
—
CA
Enumeration date
05/19/2006
Last updated
07/28/2008
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