Individual
JAY DE LEON CARIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2675 IRVINE AVE, #116, COSTA MESA, CA 92627-4653
(949) 631-0200
Mailing address
429 E 1ST ST, TUSTIN, CA 92780-3311
(760) 408-3993
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48626
CA
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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