Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | NP95008787 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | NP95008787 | CA |
NPI | 1033765839 |
---|---|
Provider Name | Jeany Leong Kung |
First Address | Monterey Park, CA 91754-7015 |
Second Address | Monterey Park, CA 91754-7015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2019 |
Last Update Date | 16/08/2019 |