Provider Demographics
NPI:1255590410
Name:LEONG, SHARON F (OD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:F
Last Name:LEONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SUITE #107 BOX 20845
Mailing Address - Street 2:PACIFIC PLAZA BUILDING # 20845
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5020
Mailing Address - Country:US
Mailing Address - Phone:760-763-1757
Mailing Address - Fax:
Practice Address - Street 1:SUITE #107 BOX 20845
Practice Address - Street 2:PACIFIC PLAZA BUILDING # 20845
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5020
Practice Address - Country:US
Practice Address - Phone:760-763-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10366T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist