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General NPI Number Information
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NPI Number | 1992885990
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Entity Type | Organization
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Legal Business Name | KAREN L LEUNG WOMEN'S WELLNESS AND GYN SURGERY CENTER
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 4655 HOEN AVE SUITE 8
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City | SANTA ROSA
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State | CA
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Zip | 95405-7800
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Country | US
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Telephone | 707-545-8881
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Fax | 707-545-8585
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Provider Business Mailing Address
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Address Line | 4655 HOEN AVE SUITE 8
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City | SANTA ROSA
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State | CA
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Zip | 95405-7800
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Country | US
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Telephone | 707-545-8881
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Fax | 707-545-8585
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Authorized Official
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Title or Position | OWNER
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Name | KAREN LIN-YEE LEUNG
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Credential | MD
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Telephone | 707-545-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | A74370
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License Number State | CA
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