Provider Demographics
NPI:1588951768
Name:GUERRA, LESLEY KOBASHI (OD)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:KOBASHI
Last Name:GUERRA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 W D ST
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2612
Mailing Address - Country:US
Mailing Address - Phone:559-924-4417
Mailing Address - Fax:
Practice Address - Street 1:162 W D ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2612
Practice Address - Country:US
Practice Address - Phone:559-924-4417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14155152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist