MEDICARE: BOB AND DEBORAH CHEN DPM INC

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E4379	CA

General Provider Information

NPI Number	:	1396908471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOB AND DEBORAH CHEN DPM INC

Provider Business Mailing Address
First Line	:	1908 BENECIA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5150
Country	:	US
Telephone Number	:	626-242-4046
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK EAST SUITE 1500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2021
Country	:	US
Telephone Number	:	310-553-2882
Fax Number	:	323-879-2088

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. DEBORAH CHEN
Credential	:	DPM
Telephone Number	:	626-242-4046

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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