Leesa Li-Fossum, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A184625 Issued in CA

Practice address

971 Lane Ave
Chula Vista, CA 91914-3501

Phone

(619) 502-7300

NPI assigned

Mar 30, 2020

Last updated

Jul 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Scripps Health

  dba Scripps Clinic

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment NPD
• Scripps Health

  dba Scripps Home Health Care Services

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  dba Scripps Coastal Medical Center

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1881636108

  Pediatrics

  NPD
• Scripps Health

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1427034990
  NPD (past)
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD (past)

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1528696127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-502-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LANE AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143501",
            "telephone_number": "619-502-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI-FOSSUM",
        "first_name": "LEESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A184625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Leyva
• Ashley Leyva
• Monique Leyva
• Olivia Michelle Leyva
• Maria Esther Lhotak, MFT
• Jeffrey Liao
• Arthur Librea, PHARM.D.
• Melinda Liburd, DR.
• Derek Martin Lichter, D.D.S.
• Carmen Gabriela Liera, LCSW

• Pediatrics Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.