Healthcare Provider Details

I. General information

NPI: 1922968676
Provider Name (Legal Business Name): DAVID LEON FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 E CESAR CHAVEZ BLVD
SAN LUIS AZ
85349
US

IV. Provider business mailing address

10590 E SHALE DR
YUMA AZ
85365-7191
US

V. Phone/Fax

Practice location:
  • Phone: 928-627-8871
  • Fax:
Mailing address:
  • Phone: 928-271-1345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number224340
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: