Active NPI
Clifford G Leong, O.D.
- Optometrist
- San Jose, CA
National Provider Identifier
1396864112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 04760T
- Practice address
- 55 E Julian St
San Jose, CA 95112-4007 - Phone
- (408) 918-2600
- Fax
- (408) 918-2693
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 04760T | CA | Primary |
Addresses
Primary practice location
55 E Julian St
San Jose, CA 95112-4007
Mailing address
18867 Aspesi Dr
Saratoga, CA 95070-5209
Phone (408) 254-5171
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04760T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396864112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18867 ASPESI DR",
"city": "SARATOGA",
"state": "CA",
"postal_code": "950705209",
"telephone_number": "408-254-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 E JULIAN ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951124007",
"telephone_number": "408-918-2600",
"fax_number": "408-918-2693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "CLIFFORD",
"middle_name": "G",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "04760T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.