Individual provider Active NPI

Leo H. Kan, DO

  • Ophthalmology Physician
  • Placentia, CA
National Provider Identifier
1447338926
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20A9163 Issued in CA
Practice address
377 E Chapman Ave
Ste 240
Placentia, CA 92870-5091
Phone
(714) 572-2039
NPI assigned
Nov 1, 2006
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 1433 SC
Ophthalmology Physician 207W00000X OP60291650 WA
Ophthalmology Physician 207W00000X 20A9163 CA Primary

Addresses

Primary practice location

377 E Chapman Ave
Ste 240
Placentia, CA 92870-5091

Mailing address

425 W Bonita Ave
Ste 110
San Dimas, CA 91773-2543
Phone (559) 585-3937

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
I20190312000814 CA Practitioner - Ophthalmology 1951333244 Practice locations: Delano, CA; Fresno, CA; Lancaster, CA; Modesto, CA; San Dimas, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Lake Erie College of Osteopathic Medicine, Erie, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1611 Scenic Dr
Modesto, CA 95355-4907
Phone (209) 523-5667

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9163CAMDAddiction (Substance Use Disorder) Counselor
1433SCMDClinical Child & Adolescent Psychologist
1003NVMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1447338926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W BONITA AVE",
            "address_2": "STE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732543",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 E CHAPMAN AVE",
            "address_2": "STE 240",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705091",
            "telephone_number": "714-572-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAN",
        "first_name": "LEO",
        "middle_name": "H.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "1433",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "OP60291650",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "20A9163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.