Healthcare Provider Details

I. General information

NPI: 1720978281
Provider Name (Legal Business Name): POLLYANNA JEN LEUNG
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W STEWART DR
ORANGE CA
92868-3849
US

IV. Provider business mailing address

19 APRILLA
IRVINE CA
92614-0230
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8000
  • Fax:
Mailing address:
  • Phone: 949-400-3892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90079
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: