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31897 Del Obispo St Ste 100 San Juan Capistrano CA 92675-3207 | |
| (760) 500-6197 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 31897 Del Obispo St Ste 100, San Juan Capistrano, California |
| Authorized Official Name and Position | Randal Leoni (OWNER DENTIST) |
| Authorized Official Contact | 7605006197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
31897 Del Obispo St Ste 100 San Juan Capistrano CA 92675-3207 Ph: (949) 661-2290 | 31897 Del Obispo St Ste 100 San Juan Capistrano CA 92675-3207 Ph: (760) 500-6197 |
| NPI Number | 1912778960 |
|---|---|
| Provider Enumeration Date | 01/09/2024 |
| Last Update Date | 11/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912778960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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