Individual
DR. DAVID W. LEECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 CASA ST, SUITE 170, SAN LUIS OBISPO, CA 93405-1818
(805) 540-5035
(805) 540-5036
Mailing address
35 CASA ST, SUITE 170, SAN LUIS OBISPO, CA 93405-1818
(805) 540-5035
(805) 540-5036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G61315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G613150
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G613150
—
CA
01
—
G61315
BLUE CROSS
CA
Enumeration date
03/14/2006
Last updated
07/03/2012
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