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NPI Code Detail

MEDICARE: MRS. PAULINE P. LEONG MS, RDN

MEDICARE: MRS. PAULINE P. LEONG MS, RDN
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
1133V00000XRegistered Dietitian838470CA
2133VN1004XPediatric Nutrition Registered Dietitian838470CA

General Provider Information

NPI Number : 1285842203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAULINE P. LEONG MS, RDN
Provider Business Mailing Address
First Line : 9551 BROADWAY APT 1
Second Line :
City : TEMPLE CITY
State : CA
Zip : 91780-3162
Country : US
Telephone Number : 626-975-6859
Fax Number :
Provider Business Practice Location Address
First Line : 4700 W SUNSET BLVD FL 3
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6070
Country : US
Telephone Number : 323-783-7633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 11/17/2021

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