Provider Demographics
NPI:1124194907
Name:DELEON, EPIFANIO JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:EPIFANIO
Middle Name:JOSE
Last Name:DELEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1839 YGNACIO VALLEY RD # B144
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3214
Mailing Address - Country:US
Mailing Address - Phone:925-289-2171
Mailing Address - Fax:888-368-4347
Practice Address - Street 1:1210 ROSSMOOR PKWY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2501
Practice Address - Country:US
Practice Address - Phone:925-933-1210
Practice Address - Fax:925-933-2051
Is Sole Proprietor?:No
Enumeration Date:2006-11-25
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA75985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A759851Medicare ID - Type Unspecified
H59577Medicare UPIN