Provider Demographics
NPI:1154684553
Name:MASLIN, JESSICA SHANSHAN (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:SHANSHAN
Last Name:MASLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:SHANSHAN
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:311 DEL MAR AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3908
Mailing Address - Country:US
Mailing Address - Phone:619-427-3355
Mailing Address - Fax:619-427-0955
Practice Address - Street 1:311 DEL MAR AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3908
Practice Address - Country:US
Practice Address - Phone:619-427-3355
Practice Address - Fax:619-427-0955
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA140884207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program