Provider Demographics
NPI:1215105994
Name:STEVEN J LESSLEY OD
Entity type:Organization
Organization Name:STEVEN J LESSLEY OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LESSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:559-688-1660
Mailing Address - Street 1:1082 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2251
Mailing Address - Country:US
Mailing Address - Phone:559-688-1660
Mailing Address - Fax:559-688-3477
Practice Address - Street 1:1082 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2251
Practice Address - Country:US
Practice Address - Phone:559-688-1660
Practice Address - Fax:559-688-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8268332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0082680Medicaid
CAT10669Medicare UPIN
CASD0082680Medicare PIN
CA0303390001Medicare NSC