MEDICARE: DR. LEONARD TSUNG-WEI ONG M.D.

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	2085B0100X	Body Imaging Physician	A122632	CA
2	2085R0202X	Diagnostic Radiology Physician	2023-02351	NC
3	2085R0202X	Diagnostic Radiology Physician	271674	NY
4	2085R0202X	Diagnostic Radiology Physician	A122632	CA

General Provider Information

NPI Number	:	1376854281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD TSUNG-WEI ONG M.D.

Provider Business Mailing Address
First Line	:	PO BOX 232410
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92193-2410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2428 SANTA MONICA BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2045
Country	:	US
Telephone Number	:	310-315-1000
Fax Number	:

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

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	02/11/2026

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