Basic Information
| Provider Information | |||||||||
| NPI: | 1386066207 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEUNG | ||||||||
| FirstName: | SAMUEL | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2825 E BARNETT RD # MSS | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975048332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417894281 | ||||||||
| FaxNumber: | 5417894806 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 SW RAMSEY AVE STE 205 | ||||||||
| Address2: | |||||||||
| City: | GRANTS PASS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975275863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414727810 | ||||||||
| FaxNumber: | 5414727811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2014 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DO179678 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.