MEDICARE: CECILIA WONG LEUNG L.AC.

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	171100000X	Acupuncturist	14700	CA

General Provider Information

NPI Number	:	1912265463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA WONG LEUNG L.AC.

Provider Business Mailing Address
First Line	:	501B ALVARADO ST
Second Line	:
City	:	BRISBANE
State	:	CA
Zip	:	94005-1658
Country	:	US
Telephone Number	:	415-271-6954
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 BUSH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-5308
Country	:	US
Telephone Number	:	415-271-6954
Fax Number	:

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

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	05/02/2012

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Directions to “ CECILIA WONG LEUNG L.AC.” Practice Location

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