Healthcare Provider Details

I. General information

NPI: 1356390538
Provider Name (Legal Business Name): JENNY S. CHOI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 S BRISTOL ST STE 207
SANTA ANA CA
92704-7431
US

IV. Provider business mailing address

3930 S BRISTOL ST STE 207
SANTA ANA CA
92704-7431
US

V. Phone/Fax

Practice location:
  • Phone: 714-957-2704
  • Fax: 714-557-4492
Mailing address:
  • Phone: 714-957-2704
  • Fax: 714-557-4492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11301T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: