Provider Demographics
NPI:1518961069
Name:LEONG, RUSSELL EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:EVAN
Last Name:LEONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:ROOM 208
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1522
Mailing Address - Country:US
Mailing Address - Phone:415-221-0320
Mailing Address - Fax:415-221-0329
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:RM 108
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1504
Practice Address - Country:US
Practice Address - Phone:415-221-0320
Practice Address - Fax:415-221-0329
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2007-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG40648207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy