Healthcare Provider Details

I. General information

NPI: 1770182990
Provider Name (Legal Business Name): RICKY T LEUNG PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 TELO AVE STE 130
TORRANCE CA
90505-4036
US

IV. Provider business mailing address

1000 N DOS ROBLES PL
ALHAMBRA CA
91801-1221
US

V. Phone/Fax

Practice location:
  • Phone: 310-833-1334
  • Fax: 310-833-0270
Mailing address:
  • Phone: 626-863-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA58923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: