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General NPI Number Information
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NPI Number | 1801784491
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Entity Type | Individual
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Provider Name | NATHAN QUIN LEUNG OD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 520 N LONE HILL AVE
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City | SAN DIMAS
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State | CA
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Zip | 91773-1725
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Country | US
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Telephone | 909-394-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 AVONREA RD
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City | SAN MARINO
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State | CA
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Zip | 91108-2305
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Country | US
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Telephone | 562-291-9749
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35958
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License Number State | CA
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