Individual provider Active NPI

Tori Leon, OD

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1205509536
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34870 Issued in CA
Practice address
878 Eastlake Pkwy Ste 1010
Chula Vista, CA 91914-4546
Phone
(619) 216-4582
Fax
(619) 482-4726
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34870 CA Primary

Addresses

Primary practice location

878 Eastlake Pkwy Ste 1010
Chula Vista, CA 91914-4546

Mailing address

878 Eastlake Pkwy Ste 1010
Chula Vista, CA 91914-4546
Phone (619) 216-4582

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
I20230530000263 CA Practitioner - Optometry 6406213966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34870CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1205509536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 EASTLAKE PKWY STE 1010",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144546",
            "telephone_number": "619-216-4582",
            "fax_number": "619-482-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 EASTLAKE PKWY STE 1010",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144546",
            "telephone_number": "619-216-4582",
            "fax_number": "619-482-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "TORI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.