Healthcare Provider Details

I. General information

NPI: 1811627185
Provider Name (Legal Business Name): BRYAN LEDESMA ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2922 E CHAPMAN AVE STE 201
ORANGE CA
92869-3711
US

IV. Provider business mailing address

PO BOX 1573
SANTA ANA CA
92702-1573
US

V. Phone/Fax

Practice location:
  • Phone: 714-787-9594
  • Fax:
Mailing address:
  • Phone: 714-787-9594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1316
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: