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Individual

MR. CHARLES DELEON LUMBOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
311 OAK ST APT 511, OAKLAND, CA 94607-4606
(510) 387-6708
Mailing address
311 OAK ST APT 511, OAKLAND, CA 94607-4606
(510) 387-6708

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95001958
CA
363LF0000X
Family Nurse Practitioner
Primary
NP95001958
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
733932
CALIFORNIA RN LICENSE
CA
01
95001958
CA BRN FAMILY NURSE PRACTITIONER
CA
Enumeration date
12/23/2014
Last updated
06/14/2024
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