MEDICARE: DILLON C CHEN MD

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	2085R0202X	Diagnostic Radiology Physician	A61802	CA
2	2085R0202X	Diagnostic Radiology Physician	L1819	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740277060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLON C CHEN MD

Provider Business Mailing Address
First Line	:	1541 ROCHESTER WAY
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-5485
Country	:	US
Telephone Number	:	512-705-3953
Fax Number	:

Provider Business Practice Location Address
First Line	:	4860 Y ST STE 3100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817
Country	:	US
Telephone Number	:	916-734-0681
Fax Number	:

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	09/16/2019

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