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General NPI Number Information
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NPI Number | 1376593467
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Entity Type | Individual
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Provider Name | LEONITA A CARUNGCONG MD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2755 HERNDON
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City | CLOVIS
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State | CA
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Zip | 93612
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Country | US
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Telephone | 559-324-4066
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Fax | 559-324-4000
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Provider Business Mailing Address
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Address Line | PO BOX 45123
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City | SAN FRANCISCO
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State | CA
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Zip | 94145
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Country | US
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Telephone | 209-956-7725
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Fax | 209-956-7733
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A69497
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License Number State | CA
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