Provider Demographics
NPI:1487540951
Name:ASANGA, LESLIE (PHARMD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:ASANGA
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 1:4240 SAXTON GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4354
Mailing Address - Country:US
Mailing Address - Phone:405-436-0220
Mailing Address - Fax:
Practice Address - Street 1:10410 S DECATUR BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-8720
Practice Address - Country:US
Practice Address - Phone:405-436-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist