Chantelle Verduzco Davis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34150TLG Issued in CA

Practice address

3404 Adams Ave
San Diego, CA 92116-2428

Phone

(619) 431-5393

Fax

(619) 431-5393

NPI assigned

Jul 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

New England College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meredith Walton OD Optometric CorporationGroup PAC ID 4183997513, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meredith Walton OD, Optometric Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1801317672
  Medicare reassignment Care Compare group NPD
• Heights Optometry

  • Optometrist
  • San Diego, CA
  • NPI 1386034163
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1235615014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162428",
            "telephone_number": "619-431-5393",
            "fax_number": "619-431-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162428",
            "telephone_number": "619-431-5393",
            "fax_number": "619-431-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUZCO DAVIS",
        "first_name": "CHANTELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34150TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hector D Verdugo
• Jessica Verdugo
• Maria Fernanda Verdugo
• Mariaelena S. Verdugo
• Wendy Thomas Verdugo
• Jesus Itzel Verduzco Moreno
• Eric Jose Verduzco
• Francisca Lizbeth Verduzco, APCC
• Jorge Emilio Verduzco Jr., NONE
• Juan Carlos Verduzco

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.