Active NPI
Yelena Davydova, OD
- Optometrist
- El Cajon, CA
National Provider Identifier
1104981042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12562T
- Practice address
- 539 Parkway PLZ
El Cajon, CA 92020-2532 - Phone
- (619) 441-0138
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12562T | CA | Primary |
Addresses
Primary practice location
539 Parkway PLZ
El Cajon, CA 92020-2532
Mailing address
8692 Lake Ashmere Dr
San Diego, CA 92119-3203
Phone (619) 957-1616
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12562T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
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.
-
- Eyewear Supplier
- Riverside, CA
- NPI 1366598120
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1104981042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8692 LAKE ASHMERE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921193203",
"telephone_number": "619-957-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "539 PARKWAY PLZ",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202532",
"telephone_number": "619-441-0138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVYDOVA",
"first_name": "YELENA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12562T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.