Individual provider Active NPI

Craig Jann Leong, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Walnut Creek, CA
National Provider Identifier
1639103344
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
G28041 Issued in CA
Practice address
365 Lennon LN Ste 250
Walnut Creek, CA 94598-5915
Phone
(925) 943-6800
Fax
(925) 943-6880
NPI assigned
Jul 10, 2006
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G28041 CA
Retina Specialist (Ophthalmology) Physician 207WX0107X G28041 CA Primary

Addresses

Primary practice location

365 Lennon LN Ste 250
Walnut Creek, CA 94598-5915

Mailing address

365 Lennon LN Ste 250
Walnut Creek, CA 94598-5915
Phone (925) 943-6800

Other practice location 1

20130 Lake Chabot Rd Ste 303
Castro Valley, CA 94546-5340
Phone (510) 733-1888

Other practice location 2

5980 Stoneridge Dr Ste 117
Pleasanton, CA 94588-2723
Phone (925) 463-8200

Other identifiers 1

IdentifierTypeStateIssuer
00G280410MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G28041CAMDRetina Specialist (Ophthalmology) Physician
28041CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Retina Associates Retina Specialist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1639103344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 LENNON LN STE 250",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985915",
            "telephone_number": "925-943-6800",
            "fax_number": "925-943-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 LENNON LN STE 250",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985915",
            "telephone_number": "925-943-6800",
            "fax_number": "925-943-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20130 Lake Chabot Rd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465340",
            "country_code": "US",
            "telephone_number": "510-733-1888",
            "fax_number": "510-881-5332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5980 Stoneridge Dr Ste 117",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945882723",
            "country_code": "US",
            "telephone_number": "925-463-8200",
            "fax_number": "925-463-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONG",
        "first_name": "CRAIG",
        "middle_name": "JANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G28041",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "G28041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G280410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.