Provider Demographics
NPI:1831190537
Name:LEUNG, MARTIN CHAN-HOI (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:CHAN-HOI
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 BOSWORTH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3262
Mailing Address - Country:US
Mailing Address - Phone:415-337-9362
Mailing Address - Fax:
Practice Address - Street 1:598 BOSWORTH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3262
Practice Address - Country:US
Practice Address - Phone:415-337-9362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G396480Medicaid
CA00G396480Medicare PIN
CAA47897Medicare UPIN