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General NPI Number Information
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NPI Number | 1124912779
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Entity Type | Individual
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Provider Name | ERIK DE LEON CMP
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Gender | Male
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2521 SAN PABLO AVE APT C
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City | BERKELEY
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State | CA
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Zip | 94702-2073
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Country | US
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Telephone | 650-888-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 SAN PABLO AVE APT C
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City | BERKELEY
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State | CA
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Zip | 94702-2073
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Country | US
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Telephone | 650-888-3039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 26471
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License Number State | CA
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