MEDICARE: DANIEL BRENT LEONG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A105830	CA
2	207R00000X	Internal Medicine Physician	A105830	CA

General Provider Information

NPI Number	:	1518119510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL BRENT LEONG MD

Provider Business Mailing Address
First Line	:	1573 ESPLANADE DR
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-9623
Country	:	US
Telephone Number	:	209-628-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	1573 ESPLANADE DR
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-9623
Country	:	US
Telephone Number	:	209-628-2911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	12/21/2012

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