Healthcare Provider Details

I. General information

NPI: 1386848000
Provider Name (Legal Business Name): DARRYL LEONG MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 CURTIS AVE # B
REDONDO BEACH CA
90278-2006
US

IV. Provider business mailing address

2202 CURTIS AVE # B
REDONDO BEACH CA
90278-2006
US

V. Phone/Fax

Practice location:
  • Phone: 310-386-0459
  • Fax:
Mailing address:
  • Phone: 310-386-0459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG83975
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG83975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: