Individual
MILDRED MADELYN DELEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12165 AEGEAN ST, NORWALK, CA 90650-1906
(562) 324-3754
Mailing address
12165 AEGEAN ST, NORWALK, CA 90650-1906
(562) 324-3754
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62580
—
CA
Enumeration date
12/12/2019
Last updated
12/12/2019
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