Healthcare Provider Details

I. General information

NPI: 1750469375
Provider Name (Legal Business Name): KENNETH L. LEUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CLARENDON AVE
SAN FRANCISCO CA
94114-2102
US

IV. Provider business mailing address

14 CLARENDON AVE
SAN FRANCISCO CA
94114-2102
US

V. Phone/Fax

Practice location:
  • Phone: 415-568-0604
  • Fax:
Mailing address:
  • Phone: 415-568-0604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberG30286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: