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Individual

MICHELLE LEONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
5601 DE SOTO AVE, WOODLAND HILLS, CA 91367-6701
(833) 574-2273
Mailing address
2430 CASA GRANDE ST, PASADENA, CA 91104-3407

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036160713
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036160713
STATE LICENSE
IL
Enumeration date
04/09/2017
Last updated
05/08/2024
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