Konkin, Leslie A.
Konkin, Leslie A. is an sole proprietor health care provider with primary practice located at 1501 Oakdale Rd Ste 301 , Modesto CA 95355-3382. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Konkin, Leslie A. can be contacted via phone (209) 571-5071.Contact Information
Primary practice address
1501 Oakdale Rd Ste 301
Modesto CA 95355-3382
Phone: (209) 571-5071
Fax: (209) 577-1157
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | G24534 | California |
Profile Details
| NPI number | 1629081195 |
|---|---|
| LBN Legal business name | Konkin, Leslie A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Apr 5th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629081195 | NPPES |
| California | Other | 00G245341 | INDIVIDUAL PTAN |
| California | MEDICAID | 9703018 | INDIVIDUAL PTAN |
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