Healthcare Provider Details
I. General information
NPI: 1841598307
Provider Name (Legal Business Name): OXANA MEJIA SILVA DE LEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/08/2011
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20800 SHERMAN WAY
WINNETKA CA
91306-2707
US
IV. Provider business mailing address
8902 WOODMAN AVE
ARLETA CA
91331-6401
US
V. Phone/Fax
- Phone: 818-883-2273
- Fax:
- Phone: 818-610-1643
- Fax: 818-715-1158
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: