Healthcare Provider Details

I. General information

NPI: 1871609446
Provider Name (Legal Business Name): PATRICK K. LEUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 03/16/2012
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:
Title or Position:
Credential:
Phone: