Provider Demographics
NPI:1841352283
Name:LEUNG, ELEANOR (MD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ALESSANDRO PL
Mailing Address - Street 2:SUITE 320
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3149
Mailing Address - Country:US
Mailing Address - Phone:626-683-0779
Mailing Address - Fax:626-683-0798
Practice Address - Street 1:50 ALESSANDRO PL
Practice Address - Street 2:SUITE 320
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3149
Practice Address - Country:US
Practice Address - Phone:626-683-0779
Practice Address - Fax:626-683-0798
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG755220207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G755220Medicaid
CA00G755220Medicaid