Individual
CHARLOTTEE DE LEOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
970 PARKSIDE ST, AZUSA, CA 91702-4242
(626) 991-6729
Mailing address
970 PARKSIDE ST, AZUSA, CA 91702-4242
(626) 991-6729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95024455
CA
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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