Provider Demographics
NPI:1962554303
Name:LEONG, GRACE YAN-CHEE (OD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:YAN-CHEE
Last Name:LEONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:395 HICKEY BLVD FL 5
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2770
Mailing Address - Country:US
Mailing Address - Phone:650-301-5869
Mailing Address - Fax:
Practice Address - Street 1:5707 CHRISTIE AVE
Practice Address - Street 2:POWELL STREET PLAZA
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2412
Practice Address - Country:US
Practice Address - Phone:510-547-8301
Practice Address - Fax:510-547-3739
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAT12832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist