Healthcare Provider Details

I. General information

NPI: 1558256685
Provider Name (Legal Business Name): JAY R JIANG ENLIGHTEN VISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 BALDWIN AVE
TEMPLE CITY CA
91780-2624
US

IV. Provider business mailing address

5422 BALDWIN AVE
TEMPLE CITY CA
91780-2624
US

V. Phone/Fax

Practice location:
  • Phone: 562-821-5025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAY JIANG
Title or Position: OWNER
Credential:
Phone: 562-821-5025