LEONARDO D MOURAO IDC NPI 1972842680

NPI Information

NPI: 1972842680
Provider Name: LEONARDO D MOURAO, IDC
Classification: Military Health Care Provider - 171000000X
Entity Type: Individual
Address:
618 PUSAN DR
OCEANSIDE, CA
ZIP 92058
Phone: (760) 725-5865
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Leonardo D Mourao, IDC is a military health care provider in Oceanside, CA. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Leonardo D Mourao, IDC NPI is 1972842680. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

618 PUSAN DR
OCEANSIDE, CA
ZIP 92058-148
Phone: (760) 725-5865

The enumeration date for this NPI number is 2/1/2013 and was last updated on 2/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171000000X	Military Health Care Provider				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	$$$$$$$$$	OTHER	CALIFORNIA	TRICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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