Provider Demographics
NPI:1982165874
Name:LEUNG, TING MEI LIN (PA)
Entity Type:Individual
Prefix:
First Name:TING
Middle Name:MEI LIN
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:TING
Other - Middle Name:MEI
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1031 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-3602
Mailing Address - Country:US
Mailing Address - Phone:213-740-9355
Mailing Address - Fax:213-740-4960
Practice Address - Street 1:1031 W 34TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-3602
Practice Address - Country:US
Practice Address - Phone:213-740-9355
Practice Address - Fax:213-740-4960
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56545363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant