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Individual

DR. JACQUELINE KATHLEEN LEKOSTAJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., PH.D.

Contact information

Practice address
2110 RUTHERFORD RD, SAN03-1051, CARLSBAD, CA 92008-7328
(760) 516-5113
Mailing address
2110 RUTHERFORD RD, SAN03-1051, CARLSBAD, CA 92008-7328
(760) 516-5113

Taxonomy

Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
A137006
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036132840
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036132840
MEDICAL LICENSE, PERMANENT
IL
01
125057763
MEDICAL LICENSE, TEMPORARY
IL
01
A137006
MEDICAL BOARD OF CALIFORNIA
CA
01
MD-41874
IOWA BOARD OF MEDICINE
IA
Enumeration date
06/17/2010
Last updated
11/03/2015
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