Jeffey O Leach, M.D. Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G30939 Issued in CA

Legal business name

JEFFEY O LEACH, M.D. INC

Practice address

2067 W Vista Way
Suite 200
Vista, CA 92083-6031

Phone

(760) 941-9844

Fax

(760) 630-5716

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Roberson

Title

Medicare Billing Specialist

Phone

(760) 941-9844

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1538195094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-941-9844",
            "fax_number": "960-630-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-941-9844",
            "fax_number": "760-630-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFEY O LEACH, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MEDICARE BILLING SPECIALIST",
        "authorized_official_telephone_number": "760-941-9844",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G30939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG309390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Vista, CA
• Providers in Vista, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.