Healthcare Provider Details

I. General information

NPI: 1366717688
Provider Name (Legal Business Name): PATRICK LEUNG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 18TH ST
BAKERSFIELD CA
93301-4824
US

IV. Provider business mailing address

804 18TH ST
BAKERSFIELD CA
93301-4824
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-3081
  • Fax: 661-323-0422
Mailing address:
  • Phone: 661-323-3081
  • Fax: 661-323-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberA331080
License Number StateCA

VIII. Authorized Official

Name: DR. PATRICK LEUNG
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 661-323-3081