Healthcare Provider Details

I. General information

NPI: 1982170841
Provider Name (Legal Business Name): JACLYNNE Y. MAGNO-CHOI, O.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13310 TELEGRAPH RD
SANTA FE SPRINGS CA
90670-4016
US

IV. Provider business mailing address

11611 CHADWICK RD
CORONA CA
92878-9450
US

V. Phone/Fax

Practice location:
  • Phone: 562-903-1618
  • Fax:
Mailing address:
  • Phone: 562-903-1618
  • Fax: 562-249-7679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JACLYNNE Y MAGNO-CHOI
Title or Position: PRESIDENT
Credential: OD
Phone: 562-903-1618