Individual
CHANNING LEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
585 N MARY AVE, SUNNYVALE, CA 94085-2905
(408) 481-3220
Mailing address
5199 CARTER AVE, SAN JOSE, CA 95118-2115
(408) 267-2779
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PT19829
CA
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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