Individual
DR. ANGEL JOSE DE LEON VACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6969 BROCKTON AVE, # B, RIVERSIDE, CA 92506-3813
(951) 686-3575
Mailing address
13355 CHERRYLAUREL AVE, MORENO VALLEY, CA 92553-6918
(951) 653-6790
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A90351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A903510
—
CA
Enumeration date
02/26/2007
Last updated
11/10/2007
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