Provider Demographics
NPI:1902279441
Name:LEUNG, ANA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:LEUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MANZANITA CT
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2848
Mailing Address - Country:US
Mailing Address - Phone:650-697-8188
Mailing Address - Fax:
Practice Address - Street 1:186 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5925
Practice Address - Country:US
Practice Address - Phone:650-871-0717
Practice Address - Fax:650-871-1419
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist