Provider Demographics
NPI:1912096918
Name:LEUNG, SELINA QUAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SELINA
Middle Name:QUAN
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BASIL CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2533
Mailing Address - Country:US
Mailing Address - Phone:408-803-2862
Mailing Address - Fax:
Practice Address - Street 1:710 LAWRENCE EXPY DEPT 362
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:669-252-3112
Practice Address - Fax:408-851-3919
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH48343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist