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Individual

LEO BACA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
25455 MEDICAL CENTER DR, MURRIETA, CA 92562-1500
(951) 587-8956
Mailing address
35081 HULIHEE ST, WINCHESTER, CA 92596-8514
(303) 944-3764

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
243U00000X
CBRPA RPA
CA
Enumeration date
11/17/2021
Last updated
11/17/2021
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