Individual
DR. JENNIE JESSICA FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1300 N VERMONT AVE, DOCTOR'S TOWER, SUITE 101, LOS ANGELES, CA 90027-6005
(323) 667-2102
Mailing address
28281 SOMERSET, MISSION VIEJO, CA 92692-2889
(949) 581-2239
(949) 472-8163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13246
CA
Other
Enumeration date
06/27/2007
Last updated
07/08/2007
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