Provider Demographics
NPI:1972558021
Name:LEUNG, VINCENT C (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:C
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2488 N CALIFORNIA ST
Mailing Address - Street 2:ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5508
Mailing Address - Country:US
Mailing Address - Phone:209-948-3333
Mailing Address - Fax:209-948-2665
Practice Address - Street 1:2488 N CALIFORNIA ST
Practice Address - Street 2:ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5508
Practice Address - Country:US
Practice Address - Phone:209-948-3333
Practice Address - Fax:209-948-2665
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2012-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG52006207X00000X, 207XS0106X, 207XS0114X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
CGP159090OtherCGP
195690700OtherUSDL
0368640001OtherDMERC
200010333OtherRR MEDICARE
CAZZZ71793ZMedicaid
A52140Medicare UPIN
CAZZZ71793ZMedicaid