MEDICARE: MR. CHRISTOPHER J JENNY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA66909	CA

General Provider Information

NPI Number	:	1306004361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER J JENNY PA-C

Provider Business Mailing Address
First Line	:	2645 OCEAN AVE LBBY 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1623
Country	:	US
Telephone Number	:	415-600-5400
Fax Number	:	415-375-4888

Provider Business Practice Location Address
First Line	:	2645 OCEAN AVE LBBY 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1623
Country	:	US
Telephone Number	:	415-600-5400
Fax Number	:	415-375-4888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/19/2026

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