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NPI Code Detail

MEDICARE: DR. JACK CHEN PHARMD

MEDICARE:  DR. JACK  CHEN  PHARMD
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
11835P1200XPharmacotherapy Pharmacist47143CA

General Provider Information

NPI Number : 1457356156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACK CHEN PHARMD
Provider Business Mailing Address
First Line : 17224 RACHELS WAY
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-6384
Country : US
Telephone Number : 909-606-2490
Fax Number : 909-606-2490
Provider Business Practice Location Address
First Line : 17224 RACHELS WAY
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-6384
Country : US
Telephone Number : 909-469-5602
Fax Number : 909-469-5539
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 08/15/2015

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Directions to “ DR. JACK CHEN PHARMD” Practice Location

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