Active NPI
Leslie Charles Bender, OD
- Optometrist
- Huntington Beach, CA
National Provider Identifier
1245223163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5991
- Practice address
- 20932 Brookhurst St
Ste 208
Huntington Beach, CA 92646-6638 - Phone
- (714) 962-3371
- Fax
- (714) 962-3745
- NPI assigned
- Aug 25, 2005
- Last updated
- Mar 13, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5991 | CA | Primary |
Addresses
Primary practice location
20932 Brookhurst St
Ste 208
Huntington Beach, CA 92646-6638
Mailing address
20932 Brookhurst St
Ste 208
Huntington Beach, CA 92646-6638
Phone (714) 962-3371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0059910 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5991 | CA | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kate Ho | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1245223163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20932 BROOKHURST ST",
"address_2": "STE 208",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926466638",
"telephone_number": "714-962-3371",
"fax_number": "714-962-3745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20932 BROOKHURST ST",
"address_2": "STE 208",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926466638",
"telephone_number": "714-962-3371",
"fax_number": "714-962-3745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDER",
"first_name": "LESLIE",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5991",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0059910",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.