Individual provider Active NPI

Kalli K Leung, O.D

  • Optometrist
  • San Leandro, CA
National Provider Identifier
1730335472
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13609 Issued in CA
Practice address
1371 E 14TH St
Suite a
San Leandro, CA 94577-4728
Phone
(510) 895-2020
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13609 CA Primary

Addresses

Primary practice location

1371 E 14TH St
Suite a
San Leandro, CA 94577-4728

Mailing address

1371 E 14TH St
Suite a
San Leandro, CA 94577-4728
Phone (510) 895-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091217000394 CA Practitioner - Optometry 4789724089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1371 E 14TH St
Suite a
San Leandro, CA 94577-4728
Phone (510) 895-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13609CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kalli Leung, O.D., Professional Corporation Optometrist CurrentSince Mar 12, 2012 Accepting new patients

Locations

1371 E 14th St
Ste A
San Leandro, CA 94577
Phone (510) 895-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1730335472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 E 14TH ST",
            "address_2": "SUITE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774728",
            "telephone_number": "510-895-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 E 14TH ST",
            "address_2": "SUITE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774728",
            "telephone_number": "510-895-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "KALLI",
        "middle_name": "K",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.