Organization
DR LEONARDO CHACON, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARDO CHACON (PRESIDENT)
(310) 835-2147
Entity
Organization
Contact information
Practice address
1721 WILMINGTON BLVD, WILMINGTON, CA 90744
(310) 835-2147
Mailing address
28832 LEAH CIRCLE, RANCHO PALOS VERDES, CA 90275
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
A327050
CA
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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