Healthcare Provider Details
I. General information
NPI: 1558407643
Provider Name (Legal Business Name): JOHN WING PUI LEUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1551 E TANGERINE RD
ORO VALLEY AZ
85755-6213
US
IV. Provider business mailing address
3157 N RAINBOW BLVD # 518
LAS VEGAS NV
89108-4578
US
V. Phone/Fax
- Phone: 520-901-3500
- Fax: 659-235-6176
- Phone: 702-386-4700
- Fax: 702-386-4701
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | G89183 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 21943 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | 21943 |
| License Number State | SC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 21943 |
| License Number State | SC |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 13979 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: