Individual
DIEGO LESCANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1420 N TRACY BLVD, TRACY, CA 95376-3451
(209) 832-6018
Mailing address
427 ALVARADO ST, BRISBANE, CA 94005-1603
(415) 756-2548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
58606
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2020
Last updated
07/24/2022
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