Provider Demographics
NPI:1467747725
Name:ALBERT G. LEUNG, DDS, INC
Entity Type:Organization
Organization Name:ALBERT G. LEUNG, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-279-2122
Mailing Address - Street 1:6565 BALBOA AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3154
Mailing Address - Country:US
Mailing Address - Phone:858-279-2122
Mailing Address - Fax:858-279-5495
Practice Address - Street 1:6565 BALBOA AVE
Practice Address - Street 2:STE. B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3154
Practice Address - Country:US
Practice Address - Phone:858-279-2122
Practice Address - Fax:858-279-5495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty