Provider Demographics
NPI:1518060417
Name:LEONG, TOMMY KAI-NANG (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:KAI-NANG
Last Name:LEONG
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 7007
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-7007
Mailing Address - Country:US
Mailing Address - Phone:661-272-3777
Mailing Address - Fax:661-272-9107
Practice Address - Street 1:HERITAGE HEALTHCARE / 2260 EAST PALMDALE BLVD.
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550
Practice Address - Country:US
Practice Address - Phone:661-272-3777
Practice Address - Fax:661-272-9107
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A544570Medicaid
CAG13131Medicare UPIN
CA00A544570Medicaid