Provider Demographics
NPI:1598936395
Name:VALENTI, CLAUDE ANTHONY (OD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:ANTHONY
Last Name:VALENTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 VILLA LA JOLLA DRIVE
Mailing Address - Street 2:B128
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1705
Mailing Address - Country:US
Mailing Address - Phone:858-453-0442
Mailing Address - Fax:858-453-5291
Practice Address - Street 1:8950 VILLA LA JOLLA DRIVE
Practice Address - Street 2:B128
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1705
Practice Address - Country:US
Practice Address - Phone:858-453-0442
Practice Address - Fax:858-453-5291
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WOP7608AOtherMEDICARE PPN PROVIDER GRP
T70212Medicare UPIN
WOP7608AOtherMEDICARE PPN PROVIDER GRP