Individual provider Active NPI

Jason Leung

  • Pharmacist
  • Manteca, CA
National Provider Identifier
1871009191
Registry record updated Dec 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77306 Issued in CA
Practice address
1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone
(209) 825-3700
NPI assigned
Dec 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77306 CA Primary

Addresses

Primary practice location

1777 W Yosemite Ave
Manteca, CA 95337-5130

Mailing address

66 Amberwood Cir
South San Francisco, CA 94080-3462
Phone (650) 267-1737

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
77306CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513900800000",
    "number": "1871009191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 AMBERWOOD CIR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803462",
            "telephone_number": "650-267-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375130",
            "telephone_number": "209-825-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-22",
        "last_updated": "2017-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; 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.