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General NPI Number Information
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NPI Number | 1801615950
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Entity Type | Organization
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Legal Business Name | R M DELEON M D INC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 4553 GLENCOE AVE STE 100
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City | MARINA DEL REY
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State | CA
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Zip | 90292-7917
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Country | US
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Telephone | 949-988-7800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | OWNER
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Name | RANDALL DELEON
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Credential | MD
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Telephone | 310-792-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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