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General NPI Number Information
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NPI Number | 1760407621
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Entity Type | Organization
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Legal Business Name | J & L DE LEON MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 16660 PARAMOUNT BLVD SUITE # 211
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City | PARAMOUNT
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State | CA
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Zip | 90723-5433
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Country | US
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Telephone | 562-633-5438
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Fax | 562-633-1685
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Provider Business Mailing Address
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Address Line | 16660 PARAMOUNT BLVD SUITE # 211
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City | PARAMOUNT
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State | CA
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Zip | 90723-5433
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Country | US
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Telephone | 562-633-5438
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Fax | 562-633-1685
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESSE MATA DE LEON
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Credential | M.D.
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Telephone | 562-633-5438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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