Provider Demographics
NPI:1992193635
Name:TENG, LEEKONG (LAC)
Entity Type:Individual
Prefix:
First Name:LEEKONG
Middle Name:
Last Name:TENG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:9626 SMOKE TREE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7260
Mailing Address - Country:US
Mailing Address - Phone:714-968-2185
Mailing Address - Fax:
Practice Address - Street 1:18821 DELAWARE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1926
Practice Address - Country:US
Practice Address - Phone:714-843-6465
Practice Address - Fax:714-843-6468
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist