Basic Information
| Provider Information | |||||||||
| NPI: | 1972145316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEL CARMEN | ||||||||
| FirstName: | LEONEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10155 COLIMA RD | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906032042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626920383 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3727 W 6TH ST STE 402 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900205112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2133657400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2019 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1041C0700X | 111129 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.