Provider Demographics
NPI:1306347281
Name:LEYTON, CARLOS E
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:LEYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:
Other - Last Name:LEYTON
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9021 EMPEROR AVE APT D
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-2064
Mailing Address - Country:US
Mailing Address - Phone:213-216-9116
Mailing Address - Fax:
Practice Address - Street 1:9021 EMPEROR AVE APT D
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-2064
Practice Address - Country:US
Practice Address - Phone:213-216-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)