Provider Demographics
NPI:1316248198
Name:LESLIE, DANIEL ALEXANDER (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ALEXANDER
Last Name:LESLIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13439 CAMINO CANADA
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-8811
Mailing Address - Country:US
Mailing Address - Phone:619-390-1146
Mailing Address - Fax:619-390-7833
Practice Address - Street 1:13439 CAMINO CANADA
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-8811
Practice Address - Country:US
Practice Address - Phone:619-390-1146
Practice Address - Fax:619-390-7833
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist