Individual
DAVID LEOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1 ADMINISTRATION CIRCLE BLDG 1403 STOP1311, CHINA LAKE, CA 93555
(760) 763-3697
Mailing address
ADULT MEDICAL CARE CLINIC, 1546 6TH STREET, TWENTYNINE PALMS, CA 92277
(760) 830-2621
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
17I0I1002X
CA
363A00000X
Physician Assistant
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932182052
US NAVY TRICARE
CA
Enumeration date
09/20/2012
Last updated
05/08/2026
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