Provider Demographics
NPI:1932767977
Name:LEUNG, CRYSTAL (PHARMD, BCOP, BCPS)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PHARMD, BCOP, BCPS
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:LEUNG
Other - Last Name:DOBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9090 WILSHIRE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1848
Mailing Address - Country:US
Mailing Address - Phone:310-967-7602
Mailing Address - Fax:
Practice Address - Street 1:9090 WILSHIRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1848
Practice Address - Country:US
Practice Address - Phone:310-967-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648501835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology