Provider Demographics
NPI:1346289089
Name:LEUNG, PUIFUNG ALICE (AUD)
Entity Type:Individual
Prefix:
First Name:PUIFUNG
Middle Name:ALICE
Last Name:LEUNG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2464
Mailing Address - Country:US
Mailing Address - Phone:415-346-6886
Mailing Address - Fax:415-776-6892
Practice Address - Street 1:3150 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2464
Practice Address - Country:US
Practice Address - Phone:415-346-6886
Practice Address - Fax:415-776-6892
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1813231H00000X
CAHA3765237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0018130Medicaid
CAAU0018130Medicaid
CAZZZ03878ZMedicare PIN