Provider Demographics
NPI:1871609446
Name:LEUNG, PATRICK K (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:K
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 1:804 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4824
Mailing Address - Country:US
Mailing Address - Phone:661-323-3081
Mailing Address - Fax:661-323-0422
Practice Address - Street 1:804 18TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4824
Practice Address - Country:US
Practice Address - Phone:661-323-3081
Practice Address - Fax:661-323-0422
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA331080207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A331080Medicaid
CAC03917Medicare UPIN
CA00A331080Medicare ID - Type Unspecified