| Leonard J. Pung, Ph.d., A Psych. Corp. | |
|
42525 Rancho Mirage Ln Rancho Mirage CA 92270-4312 | |
| (760) 880-2002 | |
| (760) 341-1333 |
| Full Name | Leonard J. Pung, Ph.d., A Psych. Corp. |
|---|---|
| Speciality | Psychologist |
| Location | 42525 Rancho Mirage Ln, Rancho Mirage, California |
| Authorized Official Name and Position | Leonard Joseph Weston (PRESIDENT) |
| Authorized Official Contact | 7603465757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonard J. Pung, Ph.d., A Psych. Corp. 72810 Ambrosia St Palm Desert CA 92260-5971 Ph: (760) 346-5757 | Leonard J. Pung, Ph.d., A Psych. Corp. 42525 Rancho Mirage Ln Rancho Mirage CA 92270-4312 Ph: (760) 880-2002 |
| NPI Number | 1437304706 |
|---|---|
| Provider Enumeration Date | 11/29/2008 |
| Last Update Date | 12/09/2008 |
| Medicare PECOS PAC ID | 1951462738 |
|---|---|
| Medicare Enrollment ID | O20081211000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437304706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY5789 (California) | Primary |
| Provider Name | Leonard J Weston |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1073665113 PECOS PAC ID: 6608937461 Enrollment ID: I20081211000673 |
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