Bruce Norman Leistikow, MD is a
Preventive Medicine - Occupational Medicine physician based in Davis, California. Bruce Norman Leistikow is licensed to practice in California (license number G80992) and his current practice location is 1 Shields Ave, Davis, California. He can be reached at his office (for appointments etc.) via phone at
(530) 752-1011.
NPI number for Bruce Norman Leistikow is 1265449169 and his current mailing address is 3410 Monte Vista Ave, Davis, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1265449169.
Physician's Profile
| Full Name | Bruce Norman Leistikow |
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| Gender | Male |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 1 Shields Ave, Davis, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1265449169
- Provider Enumeration Date: 08/02/2006
- Last Update Date: 02/15/2013
Medical Identifiers
Medical identifiers for Bruce Norman Leistikow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265449169 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | G80992 (California) | Secondary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | G80992 (California) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | G80992 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bruce Norman Leistikow is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Bruce Norman Leistikow, MD
3410 Monte Vista Ave,
Davis, CA 95618-4931
Ph: () - | Bruce Norman Leistikow, MD
1 Shields Ave,
Davis, CA 95616-5270
Ph: (530) 752-1011 |
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