Pauline P. Leong, MS, RDN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

838470 Issued in CA

Practice address

4700 W Sunset Blvd FL 3
Los Angeles, CA 90027-6070

Phone

(323) 783-7633

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1285842203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9551 BROADWAY APT 1",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917803162",
            "telephone_number": "626-975-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W SUNSET BLVD FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276070",
            "telephone_number": "323-783-7633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9551 Broadway Apt 1",
            "address_purpose": "LOCATION",
            "city": "Temple City",
            "state": "CA",
            "postal_code": "917803162",
            "country_code": "US",
            "telephone_number": "626-975-6859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONG",
        "first_name": "PAULINE",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "838470",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "CA",
            "license": "838470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4700 W Sunset Blvd Fl 3",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daisy Leong, PHARMD, BCPS
• Derek Wei-Feng Leong, MD
• Hanna Leong
• Kelly Leigh Leong
• Matthew Leong
• Stephanie Y. Leong, MD
• Tawny Leong
• Leonidas a. Johnson, O.D., a Professional Corporation (eYe cLinic OPTOMETRY)
• Gabriela Leonor Guzman
• Paul Leonor, M.D.

• Pediatric Nutrition Registered Dietitian in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Nutrition Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.