Basic Information
| Provider Information | |||||||||
| NPI: | 1164621066 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KY | ||||||||
| FirstName: | LENG | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16955 VIA DEL CAMPO STE 215 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921277720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586736199 | ||||||||
| FaxNumber: | 8586736110 | ||||||||
| Practice Location | |||||||||
| Address1: | 16955 VIA DEL CAMPO STE 215 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921277720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516750530 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 01/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A104049 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | A104049 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.