Provider Demographics
NPI:1982170841
Name:JACLYNNE Y. MAGNO-CHOI, O.D. INC
Entity Type:Organization
Organization Name:JACLYNNE Y. MAGNO-CHOI, O.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACLYNNE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MAGNO-CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-903-1618
Mailing Address - Street 1:11611 CHADWICK RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9450
Mailing Address - Country:US
Mailing Address - Phone:562-903-1618
Mailing Address - Fax:
Practice Address - Street 1:13310 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-4016
Practice Address - Country:US
Practice Address - Phone:562-903-1618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty