Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A132913 | CA |
NPI | 1003174897 |
---|---|
Provider Name | Dr. Mark-Neil Ledesma |
First Address | Temecula, CA 92591-3537 |
Second Address | Temecula, CA 92592-5896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 26/09/2019 |