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General NPI Number Information
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NPI Number | 1083954325
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Entity Type | Organization
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Legal Business Name | DAVID M. LECHUGA, PH.D., A.P.C.
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Dates
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Enumeration Date | 02/24/2013
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Last Update Date | 02/24/2013
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Provider Practice Location Address
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Address Line | 13 ORCHARD SUITE 103
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City | LAKE FOREST
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State | CA
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Zip | 92630-8320
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Country | US
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Telephone | 949-837-3358
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Fax | 949-837-0274
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Provider Business Mailing Address
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Address Line | 13 ORCHARD SUITE 103
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City | LAKE FOREST
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State | CA
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Zip | 92630-8320
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Country | US
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Telephone | 949-837-3358
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Fax | 949-837-0274
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID M LECHUGA
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Credential | PH.D.
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Telephone | 949-837-3358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY10139
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License Number State | CA
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