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General NPI Number Information
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NPI Number | 1396066676
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Entity Type | Organization
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Legal Business Name | JASMINE K. LEONG M.D. PROFESSIONAL CORP.
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 1280 CORONA POINTE CT #118
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City | CORONA
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State | CA
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Zip | 92879-1770
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Country | US
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Telephone | 951-817-5000
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Fax | 951-817-5002
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Provider Business Mailing Address
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Address Line | 1280 CORONA POINTE CT #118
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City | CORONA
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State | CA
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Zip | 92879-1770
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Country | US
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Telephone | 951-817-5000
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Fax | 951-817-5002
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASMINE K LEONG
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Credential | M.D.
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Telephone | 951-817-5000
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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 | G673040
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License Number State | CA
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