Organization Active NPI

Leo Li MD a Medical Corporation

  • Specialist
  • Montebello, CA
National Provider Identifier
1740503705
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G82244 Issued in CA
Legal business name
LEO LI MD A MEDICAL CORPORATION
Practice address
309 W Beverly Blvd
Montebello, CA 90640-4308
Phone
(818) 475-8014
Fax
(562) 696-4238
NPI assigned
Mar 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Authorized official

Name
Leo Li, MDNPI 1154463149
Title
President
Phone
(818) 475-8014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G82244 CA Primary

Addresses

Primary practice location

309 W Beverly Blvd
Montebello, CA 90640-4308

Mailing address

PO Box 6359
Whittier, CA 90609-6359
Phone (818) 475-8014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100309000081 CA Part B Supplier - Clinic/Group Practice 8628113198 Receives reassigned benefits from 1 practitioner
Practice locations: Montebello, CA; Whittier, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1740503705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6359",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906096359",
            "telephone_number": "818-475-8014",
            "fax_number": "562-696-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404308",
            "telephone_number": "818-475-8014",
            "fax_number": "562-696-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO LI MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-475-8014",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G82244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.