Healthcare Provider Details

I. General information

NPI: 1972078202
Provider Name (Legal Business Name): JOVAN CHRISTOPHER LEYVA NATUROPATHIC DOCTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2018
Last Update Date: 12/26/2020
Certification Date: 12/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W SAN MARCOS BLVD
SAN MARCOS CA
92078-1112
US

IV. Provider business mailing address

305 W SAN MARCOS BLVD
SAN MARCOS CA
92069-2783
US

V. Phone/Fax

Practice location:
  • Phone: 760-529-2413
  • Fax:
Mailing address:
  • Phone: 760-529-2413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: