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General NPI Number Information
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NPI Number | 1083627798
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Entity Type | Individual
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Provider Name | JASMINE KIMGOKE LEONG M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 11/23/2025
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Provider Practice Location Address
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Address Line | 2071 COMPTON AVE STE 102
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City | CORONA
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State | CA
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Zip | 92881-7279
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Country | US
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Telephone | 951-549-0200
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Fax | 951-817-5002
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 714-443-4512
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G67304
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License Number State | CA
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