Provider Demographics
NPI:1154838019
Name:LEONG, MEI LENG (PT)
Entity Type:Individual
Prefix:
First Name:MEI LENG
Middle Name:
Last Name:LEONG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MEI LENG CELESTE
Other - Middle Name:
Other - Last Name:LEONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:5687 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5687 MILES AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1267
Practice Address - Country:US
Practice Address - Phone:510-659-3602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-01
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist