MEDICARE: DR. HO-YIN LEUNG D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	63958	CA
2	1223P0300X	Periodontics	63958	CA

General Provider Information

NPI Number	:	1053715698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HO-YIN LEUNG D.D.S., M.S.

Provider Business Mailing Address
First Line	:	1516 STARDUST DR
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-4558
Country	:	US
Telephone Number	:	626-641-0754
Fax Number	:

Provider Business Practice Location Address
First Line	:	4531 PHILADELPHIA ST STE B107
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2249
Country	:	US
Telephone Number	:	909-902-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2014
Last Update Date	:	03/02/2020

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