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General NPI Number Information
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NPI Number | 1770139859
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Entity Type | Individual
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Provider Name | ELIZABETH M LEUNG PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 4354 LATHAM ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-1777
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Country | US
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Telephone | 951-642-2519
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Fax |
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Provider Business Mailing Address
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Address Line | 6021 FOXFIELD LN
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City | YORBA LINDA
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State | CA
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Zip | 92886-5822
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Country | US
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Telephone | 951-833-8618
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 15004
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License Number State | CA
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