Basic Information
| Provider Information | |||||||||
| NPI: | 1487158622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYNN | ||||||||
| FirstName: | JASMINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | O.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8372 WINSTON RD | ||||||||
| Address2: | |||||||||
| City: | STANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906801728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622531996 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16111 PLUMMER ST | ||||||||
| Address2: | |||||||||
| City: | SEPULVEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188917711 | ||||||||
| FaxNumber: | 8188959535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2018 | ||||||||
| LastUpdateDate: | 06/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 33941TLG | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.