Individual provider Active NPI

Leila Boubshait, M.D.

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1215298054
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A119599 Issued in CA
Practice address
4218 Berryesa Ave
Merced, CA 95348-8557
Phone
(626) 261-9433
NPI assigned
Jun 7, 2012
Last updated
Jun 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A119599 CA Primary

Addresses

Primary practice location

4218 Berryesa Ave
Merced, CA 95348-8557

Mailing address

315 Mercy Ave
301
Merced, CA 95340-8367
Phone (626) 261-9433

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A119599CAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1215298054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MERCY AVE",
            "address_2": "301",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408367",
            "telephone_number": "626-261-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 BERRYESA AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953488557",
            "telephone_number": "626-261-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUBSHAIT",
        "first_name": "LEILA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A119599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.