Individual provider Active NPI

Leslie C. Moretti, M.D.

  • Internal Medicine Physician
  • Daly City, CA
National Provider Identifier
1780866038
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G15299 Issued in CA
Practice address
1850 Sullivan Ave
#440
Daly City, CA 94015-2221
Phone
(650) 992-8500
Fax
(650) 992-5292
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G15299 CA Primary

Addresses

Primary practice location

1850 Sullivan Ave
#440
Daly City, CA 94015-2221

Mailing address

1850 Sullivan Ave
#440
Daly City, CA 94015-2221
Phone (650) 992-8500

Other identifiers 1

IdentifierTypeStateIssuer
00G152990MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000651 CA Practitioner - Medical OncologyPractitioner - Internal Medicine 9537297197 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G15299CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DCHS Medical Foundation Internal Medicine CurrentSince Jan 10, 2018 Accepting new patients
Verity Medical Foundation CurrentSince Jan 10, 2018 Accepting new patients

Locations

1850 Sullivan Ave
Ste 440
Daly City, CA 94015
Phone (415) 992-8500

3628 E Imperial Hwy
Ste 408
Lynwood, CA 90262
Phone (310) 554-4127

230 S Main St
Ste 100
Orange, CA 92868
Phone (714) 541-0101

500 Arguello St
Ste 100
Redwood City, CA 94063
Phone (650) 581-4900

625 Lincoln Ave
San Jose, CA 95126
Phone (408) 278-3003

Organizations & group practices 2

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1780866038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "#440",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-992-8500",
            "fax_number": "650-992-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "#440",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-992-8500",
            "fax_number": "650-992-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETTI",
        "first_name": "LESLIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G15299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G152990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.