Provider Demographics
NPI:1548533755
Name:POELNS-JOSEPH, LESLIE (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:POELNS-JOSEPH
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:PO BOX 3022
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-1022
Mailing Address - Country:US
Mailing Address - Phone:818-716-7833
Mailing Address - Fax:
Practice Address - Street 1:6752 LOS VERDES DRIVE
Practice Address - Street 2:#6
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275
Practice Address - Country:US
Practice Address - Phone:310-738-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-18
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine