Individual
LEONARDO D MOURAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
618 PUSAN DR, OCEANSIDE, CA 92058-8148
(760) 725-5865
Mailing address
1ST MLG 7TH ESB, 555677, FPO, AP 92055-0000
(760) 725-5865
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
02/01/2013
Last updated
02/01/2013
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