Individual
ALBERT VINCENT LEBOUTON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
3100 TELEGRAPH AVE STE 350, OAKLAND, CA 94609-3239
(800) 607-6377
Mailing address
3100 TELEGRAPH AVE STE 350, OAKLAND, CA 94609-3239
(800) 607-6377
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/24/2022
Last updated
07/24/2022
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