Provider Demographics
NPI:1588401822
Name:DR. JENNIFER CHINN OD APC
Entity type:Organization
Organization Name:DR. JENNIFER CHINN OD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:858-735-2056
Mailing Address - Street 1:2856 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2930
Mailing Address - Country:US
Mailing Address - Phone:619-280-0664
Mailing Address - Fax:619-294-8100
Practice Address - Street 1:2856 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-2930
Practice Address - Country:US
Practice Address - Phone:619-280-0664
Practice Address - Fax:619-294-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty