MEDICARE: DAVID R LEONG OD INC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1679257760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID R LEONG OD INC

Provider Business Mailing Address
First Line	:	2550 W EL CAMINO AVE STE 11
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-3900
Country	:	US
Telephone Number	:	916-921-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 W EL CAMINO AVE STE 11
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-3900
Country	:	US
Telephone Number	:	916-921-2020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID R LEONG
Credential	:	OD
Telephone Number	:	916-921-2020

Provider Enumeration Date	:	06/09/2023
Last Update Date	:	07/20/2023

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Directions to “DAVID R LEONG OD INC ” Practice Location

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