Provider Demographics
NPI:1194723437
Name:COCHRANE, LESLEE BERT (MD)
Entity type:Individual
Prefix:DR
First Name:LESLEE
Middle Name:BERT
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25240 HANCOCK AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5991
Mailing Address - Country:US
Mailing Address - Phone:951-200-7800
Mailing Address - Fax:
Practice Address - Street 1:25240 HANCOCK AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5991
Practice Address - Country:US
Practice Address - Phone:951-200-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72747207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE64887Medicare UPIN