Provider Demographics
NPI:1275547200
Name:LEUNG, EAMON W (MD)
Entity Type:Individual
Prefix:DR
First Name:EAMON
Middle Name:W
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 N NORTERRA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8200
Mailing Address - Country:US
Mailing Address - Phone:623-277-1128
Mailing Address - Fax:866-561-6293
Practice Address - Street 1:13041 N DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3034
Practice Address - Country:US
Practice Address - Phone:623-977-7201
Practice Address - Fax:623-876-2104
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80342207W00000X
AZ48071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0561803Medicaid
MN106618800Medicaid
AZ830190Medicaid
IN200418150Medicaid
IA0561803Medicaid
IN200418150Medicaid
AZZ160223Medicare PIN
MN106618800Medicaid