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NPI Code Detail

MEDICARE: PATRICK CHEN

MEDICARE: PATRICK CHEN
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
1261QH0100XHealth Service Clinic/CenterA88391CA

General Provider Information

NPI Number : 1104970656
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRICK CHEN
Provider Business Mailing Address
First Line : 1550 SUPERIOR AVE
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-3653
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1550 SUPERIOR AVE
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-3653
Country : US
Telephone Number : 949-650-0640
Fax Number :
Authorized Official
Title or Position : ASSOCIATE MEDICAL DIRECTOR
Name : DR. PATRICK CHU-SHIAN CHEN
Credential : M.D.
Telephone Number : 415-595-9067
Provider Enumeration Date : 01/22/2007
Last Update Date : 06/17/2008

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