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General NPI Number Information
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NPI Number | 1366519266
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Entity Type | Individual
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Provider Name | KENNETH LEONG MD
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 300 HILLMONT AVE STE 401
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City | VENTURA
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State | CA
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Zip | 93003-1651
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Country | US
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Telephone | 805-648-9830
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 48TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-6131
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Country | US
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Telephone | 818-454-6359
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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 | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | ME128087
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | G81070
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License Number State | CA
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