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Organization
STEPHEN CHINN
Active
Organization
STEPHEN CHINN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN CHINN (OWNER)
(858) 695-7276
Entity
Organization
Contact information
Practice address
45233 ANTARES DR BLDG 2660, SAN DIEGO, CA 92145-4426
(858) 695-7276
(858) 695-7378
Mailing address
45233 ANTARES DR BLDG 2660, P.O.BOX 452134, SAN DIEGO, CA 92145-4426
(858) 695-7276
(858) 695-7378
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5373
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0053731
—
CA
Enumeration date
06/02/2008
Last updated
05/28/2010
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