Individual provider Active NPI

Eva Pei-Srbich Leonard, M.D.

  • Internal Medicine Physician
  • La Mesa, CA
National Provider Identifier
1386602746
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G39845 Issued in CA
Practice address
5525 Grossmont Center Dr
Suite 200
La Mesa, CA 91942-3009
Phone
(619) 644-6500
Fax
(619) 644-6539
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G39845 CA Primary

Addresses

Primary practice location

5525 Grossmont Center Dr
Suite 200
La Mesa, CA 91942-3009

Mailing address

5525 Grossmont Center Dr
Suite 200
La Mesa, CA 91942-3009
Phone (619) 644-6500

Other identifiers 2

IdentifierTypeStateIssuer
G39845OtherCASTATE LICENSE #
330885096OtherCAOFFICE IRS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000604 CA Practitioner - Internal Medicine 0547275539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39845CAMDProsthodontist
G39845CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Oct 1, 2014 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Internal Medicine CurrentSince Oct 1, 2014 Accepting new patients

Locations

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

5525 Grossmont Center Dr
Ste 200
La Mesa, CA 91942
Phone (619) 644-6500

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386602746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 GROSSMONT CENTER DR",
            "address_2": "SUITE 200",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423009",
            "telephone_number": "619-644-6500",
            "fax_number": "619-644-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 GROSSMONT CENTER DR",
            "address_2": "SUITE 200",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423009",
            "telephone_number": "619-644-6500",
            "fax_number": "619-644-6539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "EVA",
        "middle_name": "PEI-SRBICH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G39845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "G39845",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE IRS #",
            "identifier": "330885096",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.