MEDICARE: DR. MARY CHEN D.P.T.

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
1	2251X0800X	Orthopedic Physical Therapist	PT26386	CA

General Provider Information

NPI Number	:	1386640563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY CHEN D.P.T.

Provider Business Mailing Address
First Line	:	891 N ORANGE ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-6737
Country	:	US
Telephone Number	:	714-310-9740
Fax Number	:

Provider Business Practice Location Address
First Line	:	891 N ORANGE ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-6737
Country	:	US
Telephone Number	:	714-633-3887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	10/30/2019

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