Individual
MISS AUDREY SAN LEUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 N GRAND BLVD # B719, SAINT LOUIS, MO 63106-1621
(314) 242-9583
(314) 289-7023
Mailing address
925 NORTH GRAND BLVD, ROOM B719, ST LOUIS, MO 63106
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R-10441
IA
208100000X
Physical Medicine & Rehabilitation Physician
MD61087441
WA
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
MD61087441
WA
2081P0004X
Spinal Cord Injury Medicine Physician
ML60951455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790168474
—
WA
Enumeration date
06/30/2015
Last updated
02/05/2026
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