Provider Demographics
NPI:1053848689
Name:LEEKA, JUSTIN ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANDREW
Last Name:LEEKA
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5380 S RAINBOW BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1880
Mailing Address - Country:US
Mailing Address - Phone:702-382-8222
Mailing Address - Fax:702-640-0604
Practice Address - Street 1:5380 S RAINBOW BLVD STE 330
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1880
Practice Address - Country:US
Practice Address - Phone:702-382-8222
Practice Address - Fax:702-640-0604
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-14
Last Update Date:2020-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVSL1202207Q00000X
NVDO26940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine