Healthcare Provider Details

I. General information

NPI: 1467764654
Provider Name (Legal Business Name): SHELDON LEONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 COTTONWOOD ST STE 2
WOODLAND CA
95695-3603
US

IV. Provider business mailing address

1111 EXPOSITION BLVD STE 300
SACRAMENTO CA
95815-4324
US

V. Phone/Fax

Practice location:
  • Phone: 916-929-8564
  • Fax: 916-929-4529
Mailing address:
  • Phone: 916-929-8564
  • Fax: 916-929-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA129154
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA129154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: