Provider Demographics
NPI:1699087536
Name:DELEON, JILL (DC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DELEON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 WILSHIRE BLVD
Mailing Address - Street 2:270
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-274-0022
Mailing Address - Fax:310-694-5816
Practice Address - Street 1:8907 WILSHIRE BLVD
Practice Address - Street 2:270
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1937
Practice Address - Country:US
Practice Address - Phone:310-274-0022
Practice Address - Fax:310-694-5816
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor