Most Relevant Information
Provider Data
| NPI Number: | 1003538166 |
| Provider Name: | LESLIE SAMANTHA MORENO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/15/2022 |
| Last Updated: | 06/14/2024 |
Provider Practice Location
1556 S SULTANA AVE
ONTARIO
CA
917614238
Practice Location Phone/Fax
| Phone: | 9094186923 |
| Fax: |
Provider Mailing Location
1556 S SULTANA AVE
ONTARIO
CA
917614238
Provider Mailing Phone/Fax
| Phone: | 9094186923 |
| Fax: |