Healthcare Provider Details

I. General information

NPI: 1427912005
Provider Name (Legal Business Name): DR. JENNIFER CHINN OD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2856 UNIVERSITY AVE
SAN DIEGO CA
92104-2930
US

IV. Provider business mailing address

2856 UNIVERSITY AVE
SAN DIEGO CA
92104-2930
US

V. Phone/Fax

Practice location:
  • Phone: 619-280-0664
  • Fax: 619-294-8100
Mailing address:
  • Phone: 619-280-0664
  • Fax: 619-294-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CHINN
Title or Position: OWNER
Credential: OD
Phone: 858-735-2056