Individual
MR. RAFAEL MANZON LEDESMA II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22772 CENTRE DR STE 220, LAKE FOREST, CA 92630-6303
(949) 446-9800
(949) 446-9735
Mailing address
22772 CENTRE DR STE 220, LAKE FOREST, CA 92630-6303
(949) 446-9800
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
99972D2
CA
Other
Enumeration date
07/14/2020
Last updated
07/30/2020
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