Provider Demographics
NPI:1649570375
Name:CHEN, JENNIFER MEI-YIN (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MEI-YIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2703
Mailing Address - Country:US
Mailing Address - Phone:626-376-1271
Mailing Address - Fax:
Practice Address - Street 1:140 W VALLEY BLVD STE 115
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3784
Practice Address - Country:US
Practice Address - Phone:626-288-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14056152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist