Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | WPT28266B | CA |
NPI | 1174714893 |
---|---|
Provider Name | Anthony Leseca |
First Address | Santa Clarita, CA 91390-5720 |
Second Address | Santa Clarita, CA 91390-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 07/08/2007 |