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NPI Code Detail

MEDICARE: LEON ALEXANDRA GADDI REGISTERED NURSE

MEDICARE:   LEON ALEXANDRA  GADDI  REGISTERED  NURSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH0200XHome Health Registered Nurse4705878CA
2163W00000XRegistered Nurse4705878CA

General Provider Information

NPI Number : 1548884521
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEON ALEXANDRA GADDI REGISTERED NURSE
Provider Business Mailing Address
First Line : 1308 EAST CAMBRIDGE COURT
Second Line :
City : LANCASTER
State : CA
Zip : 93535-2984
Country : US
Telephone Number : 661-247-3017
Fax Number :
Provider Business Practice Location Address
First Line : 1308 EAST CAMBRIDGE COURT
Second Line :
City : LANCASTER
State : CA
Zip : 93535-2984
Country : US
Telephone Number : 661-247-3017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2020
Last Update Date : 06/04/2020

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Directions to “ LEON ALEXANDRA GADDI REGISTERED NURSE” Practice Location

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