Provider Demographics
NPI:1740369123
Name:LEONG, JOHN TERRANCE (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:TERRANCE
Last Name:LEONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41443 COUR BEAUNE
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591
Mailing Address - Country:US
Mailing Address - Phone:951-676-6847
Mailing Address - Fax:
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD
Practice Address - Street 2:STE 205
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591
Practice Address - Country:US
Practice Address - Phone:951-676-6733
Practice Address - Fax:951-676-2833
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor