Organization Active NPI

So Deleon PC

  • Adult Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1356119770
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
SO DELEON PC
Practice address
2350 S Jones Blvd Ste 210
Las Vegas, NV 89146-3103
Phone
(725) 238-3987
NPI assigned
Dec 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Allan Michael De LeonNPI 1073201257
Title
President
Phone
(702) 972-7061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

2350 S Jones Blvd Ste 210
Las Vegas, NV 89146-3103

Mailing address

2350 S Jones Blvd Ste 210
Las Vegas, NV 89146-3103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124003279 NV Part B Supplier - Clinic/Group Practice 5092168252 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

6539 Las Vegas Blvd S
Unit 110
Las Vegas, NV 89119
Phone (725) 238-3987

2350 S Jones Blvd
Ste 210
Las Vegas, NV 89146
Phone (725) 238-3987

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1356119770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 S JONES BLVD STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S JONES BLVD STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463103",
            "telephone_number": "725-238-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO DELEON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "ALLAN MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-972-7061"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.