Provider Demographics
NPI:1982649547
Name:DR. DENNIS W. LEUNG, O.D
Entity Type:Organization
Organization Name:DR. DENNIS W. LEUNG, O.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-307-0228
Mailing Address - Street 1:230 N GARFIELD AVE
Mailing Address - Street 2:#D6
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1774
Mailing Address - Country:US
Mailing Address - Phone:626-307-0228
Mailing Address - Fax:626-307-8861
Practice Address - Street 1:230 N GARFIELD AVE
Practice Address - Street 2:#D6
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1774
Practice Address - Country:US
Practice Address - Phone:626-307-0228
Practice Address - Fax:626-307-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8179152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGSD004310Medicaid
CAGSD004310Medicaid