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General NPI Number Information
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NPI Number | 1356119770
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Entity Type | Organization
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Legal Business Name | SO DELEON PC
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2350 S JONES BLVD STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 725-238-3987
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 S JONES BLVD STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALLAN MICHAEL DE LEON
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Credential |
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Telephone | 702-972-7061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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