Healthcare Provider Details

I. General information

NPI: 1710673108
Provider Name (Legal Business Name): BRIAN LENG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18591 SOLEDAD CANYON RD
CANYON COUNTRY CA
91351-3774
US

IV. Provider business mailing address

18591 SOLEDAD CANYON RD
CANYON COUNTRY CA
91351-3774
US

V. Phone/Fax

Practice location:
  • Phone: 661-252-7778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA63732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: