Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | A39058 | CA |
Y | 208000000X | Pediatrician | A39058 | CA |
NPI | 1710066147 |
---|---|
Provider Name | Xuanto Leduc |
First Address | Fountain Valley, CA 92708-4010 |
Second Address | Fountain Valley, CA 92708-4010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2006 |
Last Update Date | 18/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A390581 | (05) | CA |
A85227 | (02) |