Provider Demographics
NPI:1346356755
Name:LEUNG, ALBERT MT (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:MT
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:PO BOX 31000
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96849-5636
Mailing Address - Country:US
Mailing Address - Phone:808-955-5929
Mailing Address - Fax:808-955-5931
Practice Address - Street 1:1481 SOUTH KING STREET
Practice Address - Street 2:SUITE 538
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2603
Practice Address - Country:US
Practice Address - Phone:808-955-5929
Practice Address - Fax:808-955-5931
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD8724207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07831903Medicaid
HIH104840Medicare PIN
HIH102406Medicare PIN
HI52029Medicare ID - Type Unspecified
HI07831903Medicaid