Active NPI
Brandon Jonathan Leong
- Physical Therapist
- South San Francisco, CA
National Provider Identifier
1043043102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 306555
- Practice address
- 61 Cymbidium Cir
South San Francisco, CA 94080-2266 - Phone
- (650) 583-1968
- NPI assigned
- Aug 23, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 306555 | CA | Primary |
Addresses
Primary practice location
61 Cymbidium Cir
South San Francisco, CA 94080-2266
Mailing address
61 Cymbidium Cir
South San Francisco, CA 94080-2266
Phone (650) 583-1968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306555 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1043043102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 CYMBIDIUM CIR",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940802266",
"telephone_number": "650-583-1968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 CYMBIDIUM CIR",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940802266",
"telephone_number": "650-583-1968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "BRANDON",
"middle_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-23",
"last_updated": "2024-08-23",
"certification_date": "2024-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "306555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.