Basic Information
| Provider Information | |||||||||
| NPI: | 1619172145 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHALEN | ||||||||
| FirstName: | LESTA | ||||||||
| MiddleName: | DELL SEGER | ||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | SEGER | ||||||||
| OtherFirstName: | LESTA | ||||||||
| OtherMiddleName: | DELL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2701 E ELVIRA RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206265485 | ||||||||
| FaxNumber: | 5206266571 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857240001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069109358 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2007 | ||||||||
| LastUpdateDate: | 11/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | 48007 | AZ | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.