Individual
ELIZABETH C LEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0043064
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000 Q6178
—
NM
05
—
407628
—
AZ
Enumeration date
11/14/2006
Last updated
04/22/2019
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