Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G43999 | CA |
N | 111NI0900X | Internist | G43999 | CA |
N | 207RH0000X | Hematologist | G43999 | CA |
Y | 207RX0202X | Medical Oncology | G43999 | CA |
NPI | 1104936459 |
---|---|
Provider Name | Ms. Lucille Leong |
First Address | Monrovia, CA 91016-4066 |
Second Address | Duarte, CA 91010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 26/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G439990 | (05) | CA |
A49517 | (02) |