Provider Demographics
NPI:1568669976
Name:LEUNG, PETER WAI KAY (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:WAI KAY
Last Name:LEUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:WAI-KAY
Other - Last Name:LEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:510 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1901
Mailing Address - Country:US
Mailing Address - Phone:909-469-9494
Mailing Address - Fax:
Practice Address - Street 1:9985 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:888-750-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine