Individual
HARVEY DENNIS LEDESMA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4124 N SIERRA WAY, SAN BERNARDINO, CA 92407-3825
(909) 883-4900
Mailing address
6550 APPLEWOOD ST, HIGHLAND, CA 92346-5210
(909) 725-1422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT12094TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OPT120941
—
CA
Enumeration date
03/16/2006
Last updated
07/08/2007
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