Active NPI
Sandra Leong, M.D.
- Gynecology Physician
- Santa Monica, CA
National Provider Identifier
1225229123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- G67680
- Practice address
- 1148 4TH St
Santa Monica, CA 90403-5091 - Phone
- (310) 458-7979
- Fax
- (310) 458-0179
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | G67680 | CA | Primary |
Addresses
Primary practice location
1148 4TH St
Santa Monica, CA 90403-5091
Mailing address
1148 4TH St
Santa Monica, CA 90403-5091
Phone (310) 458-7979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 22, 2014 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67680 | CA | MD | Pharmacist |
| G67680 | CA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1225229123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1148 4TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904035091",
"telephone_number": "310-458-7979",
"fax_number": "310-458-0179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1148 4TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904035091",
"telephone_number": "310-458-7979",
"fax_number": "310-458-0179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "SANDRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CA",
"license": "G67680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.