NPIMap

Individual provider Active NPI

Xuanto Leduc, M.D.

  • Pediatrics Physician
  • Fountain Valley, CA
National Provider Identifier
1710066147
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A39058 Issued in CA
Practice address
11160 Warner Ave
Suite 101
Fountain Valley, CA 92708-4010
Phone
(714) 540-0105
Fax
(714) 540-6727
NPI assigned
Nov 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X A39058 CA
Pediatrics Physician 208000000X A39058 CA Primary

Addresses

Primary practice location

11160 Warner Ave
Suite 101
Fountain Valley, CA 92708-4010

Mailing address

11160 Warner Ave
Suite 101
Fountain Valley, CA 92708-4010
Phone (714) 540-0105

Other identifiers 1

IdentifierTypeStateIssuer
00A390581MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180314000866 CA Practitioner - Pathology 9133386964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A39058CAMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Feb 7, 2018 Accepting new patients
Children's Hospital Los Angeles Past Accepting new patients
University of California Irvine Past Accepting new patients
Leduc Medical Group, Inc. Clinical Genetics (M.D.) PastSince Dec 10, 2011 Accepting new patients
Children's Hospital of Orange County Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Sdi Labs, Inc PastSince Oct 20, 2019 Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
Stop 90
Los Angeles, CA 90027
Phone (323) 361-2178

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1710066147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 101",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084010",
            "telephone_number": "714-540-0105",
            "fax_number": "714-540-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 101",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084010",
            "telephone_number": "714-540-0105",
            "fax_number": "714-540-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDUC",
        "first_name": "XUANTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-05",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "A39058",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A39058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A390581",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.