Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20A15253 | CA |
NPI | 1053798512 |
---|---|
Provider Name | Joycelin Leong |
First Address | Mather, CA 95655-4200 |
Second Address | Mather, CA 95655-4200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2015 |
Last Update Date | 06/08/2020 |