Individual
BRYANT C. LEUNG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4354 LATHAM ST, STE 100, RIVERSIDE, CA 92501-1777
(951) 683-0650
(951) 774-4610
Mailing address
4354 LATHAM ST, STE 100, RIVERSIDE, CA 92501-1777
(951) 683-0650
(951) 774-4612
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A69385
CA
208VP0000X
Pain Medicine Physician
A69385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250012347
RAILROAD MEDICARE
CA
Enumeration date
06/16/2005
Last updated
07/23/2019
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