Provider Demographics
NPI:1427089465
Name:ARCADIA PEDIATRIC MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:ARCADIA PEDIATRIC MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:WING-YIN
Authorized Official - Last Name:LEONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-445-8698
Mailing Address - Street 1:612 W DUARTE RD
Mailing Address - Street 2:SUITE 603
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7602
Mailing Address - Country:US
Mailing Address - Phone:626-445-8698
Mailing Address - Fax:
Practice Address - Street 1:612 W DUARTE RD
Practice Address - Street 2:SUITE 603
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7602
Practice Address - Country:US
Practice Address - Phone:626-445-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2623586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty