Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A133390 | CA |
N | 111NI0900X | Internist | A133390 | CA |
Y | 207RG0300X | Geriatric Medicine | A133390 | CA |
NPI | 1013250778 |
---|---|
Provider Name | Katrina Deleon |
First Address | San Diego, CA 92127-5705 |
Second Address | La Jolla, CA 92037-1027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 31/05/2017 |