Provider Demographics
NPI:1679143416
Name:ELEANOR LEUNG M.D. A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ELEANOR LEUNG M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:KAM FUN
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-683-0779
Mailing Address - Street 1:50 ALESSANDRO PL STE 230
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-4003
Mailing Address - Country:US
Mailing Address - Phone:626-683-0779
Mailing Address - Fax:626-683-0798
Practice Address - Street 1:50 ALESSANDRO PL STE 230
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-4003
Practice Address - Country:US
Practice Address - Phone:626-683-0779
Practice Address - Fax:626-683-0798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G755220Medicaid