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General NPI Number Information
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NPI Number | 1861127284
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Entity Type | Individual
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Provider Name | MR. BRIAN DE LEON
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Gender | Male
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 510 S VERMONT AVE # 21
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City | LOS ANGELES
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State | CA
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Zip | 90020-1992
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Country | US
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Telephone | 213-738-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 510 S VERMONT AVE # 21-M12
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City | LOS ANGELES
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State | CA
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Zip | 90020-1992
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Country | US
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Telephone | 213-332-1078
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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