Provider Demographics
NPI:1053096685
Name:CHEN, BRANDYN JIN-FUEI (OD)
Entity type:Individual
Prefix:DR
First Name:BRANDYN
Middle Name:JIN-FUEI
Last Name:CHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2067 W VISTA WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6032
Mailing Address - Country:US
Mailing Address - Phone:760-758-2020
Mailing Address - Fax:760-758-1410
Practice Address - Street 1:2067 W VISTA WAY STE 120
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6032
Practice Address - Country:US
Practice Address - Phone:760-758-2020
Practice Address - Fax:760-758-1410
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35490152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist