Provider Demographics
NPI:1528336765
Name:JENNY HUNG OD INC
Entity type:Organization
Organization Name:JENNY HUNG OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-312-2712
Mailing Address - Street 1:2827 GINGER CT
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4326
Mailing Address - Country:US
Mailing Address - Phone:714-425-4005
Mailing Address - Fax:
Practice Address - Street 1:1827 WALNUT GROVE AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3789
Practice Address - Country:US
Practice Address - Phone:626-312-2712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13252 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty