Provider Demographics
NPI:1033562772
Name:MOOSAVI, LEILA (MD)
Entity type:Individual
Prefix:DR
First Name:LEILA
Middle Name:
Last Name:MOOSAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 CHESTER AVE # 301
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2016
Mailing Address - Country:US
Mailing Address - Phone:661-863-2073
Mailing Address - Fax:
Practice Address - Street 1:2701 CHESTER AVE STE 301
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2016
Practice Address - Country:US
Practice Address - Phone:661-863-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA157504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine