Active NPI
Tiffany Leung, O.D.
- Optometrist
- San Rafael, CA
National Provider Identifier
1568778595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13996
- Practice address
- 9000 Northgate Mall
San Rafael, CA 94903 - Phone
- (415) 507-2364
- Fax
- (415) 472-6589
- NPI assigned
- Aug 27, 2010
- Last updated
- May 31, 2011
- Sex
- Female
- 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 | 13996 | CA | Primary |
Addresses
Primary practice location
9000 Northgate Mall
San Rafael, CA 94903
Mailing address
866 Southgate Ave
Daly City, CA 94015-3741
Phone (650) 303-7509
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13996 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avon Wai Kwong | Optometrist | Past | Accepting new patients |
| Leung Optometric Corporation | Optometrist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- San Rafael, CA
- NPI 1306125505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306800000000",
"number": "1568778595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 SOUTHGATE AVE",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940153741",
"telephone_number": "650-303-7509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 NORTHGATE MALL",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-507-2364",
"fax_number": "415-472-6589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEUNG",
"first_name": "TIFFANY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-27",
"last_updated": "2011-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.