Basic Information
| Provider Information | |||||||||
| NPI: | 1396000758 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEEMS | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | CHANA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 N ALVERNON WAY STE 204 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857111825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206262010 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 655 N ALVERNON WAY STE 204 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857111825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206262010 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2012 | ||||||||
| LastUpdateDate: | 09/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | DR.0056930 | CO | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 125061593 | IL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 66865 | AZ | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 34950061 | 05 | CO | MEDICAID | 028894 | 01 | CO | KAISER COMMERCIAL NUMBER | OTHER |