Provider Demographics
NPI:1326158320
Name:LO, JENNIFER SHIN-YING (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SHIN-YING
Last Name:LO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1720 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3224
Mailing Address - Country:US
Mailing Address - Phone:650-259-0300
Mailing Address - Fax:650-259-0505
Practice Address - Street 1:1720 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3224
Practice Address - Country:US
Practice Address - Phone:650-259-0300
Practice Address - Fax:650-259-0505
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12943T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist