Organization Active NPI

Leslie L. Oldenbrook, D.P.M.

  • Podiatrist
  • Los Gatos, CA
National Provider Identifier
1629130539
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E20180 Issued in CA
Legal business name
LESLIE L. OLDENBROOK, D.P.M.
Practice address
555 Knowles Dr
Suite 220
Los Gatos, CA 95032-1551
Phone
(408) 379-8450
Fax
(408) 379-2672
NPI assigned
Dec 15, 2006
Last updated
Nov 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Leslie L Oldenbrook, DPM
Title
Owner
Phone
(408) 379-8450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E20180 CA Primary

Addresses

Primary practice location

555 Knowles Dr
Suite 220
Los Gatos, CA 95032-1551

Mailing address

555 Knowles Dr
Suite 220
Los Gatos, CA 95032-1551
Phone (408) 379-8450

Other identifiers 1

IdentifierTypeStateIssuer
000E20180MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1629130539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 KNOWLES DR",
            "address_2": "SUITE 220",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321551",
            "telephone_number": "408-379-8450",
            "fax_number": "408-379-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 KNOWLES DR",
            "address_2": "SUITE 220",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321551",
            "telephone_number": "408-379-8450",
            "fax_number": "408-379-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE L. OLDENBROOK, D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "OLDENBROOK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-379-8450",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E20180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E20180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.