Carlo Alviar De Leon, PT | |
5720 Stoneridge Mall Rd, Pleasanton, CA 94588-2828 | |
(925) 847-5702 | |
Not Available |
Full Name | Carlo Alviar De Leon |
---|---|
Gender | Male |
Speciality | Physical Therapist - Orthopedic |
Location | 5720 Stoneridge Mall Rd, Pleasanton, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740493873 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251X0800X | Physical Therapist - Orthopedic | 33537 (California) | Primary |
Provider Name | Permanente Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Carlo Alviar De Leon, PT 21965 Nugget Canyon Dr, Castro Valley, CA 94552-4864 Ph: (510) 886-3261 | Carlo Alviar De Leon, PT 5720 Stoneridge Mall Rd, Pleasanton, CA 94588-2828 Ph: (925) 847-5702 |
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