Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 63958 | CA |
Y | 1223P0300X | Periodontist | 63958 | CA |
NPI | 1053715698 |
---|---|
Provider Name | Dr. Ho-Yin Leung |
First Address | West Covina, CA 91790-4558 |
Second Address | Chino, CA 91710-2249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2014 |
Last Update Date | 02/03/2020 |