MEDICARE: DAVID C. CHEN M.D.

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	208600000X	Surgery Physician	A84733	CA

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	:	1760630057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C. CHEN M.D.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	SUITE 200
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 15TH ST STE 102
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1810
Country	:	US
Telephone Number	:	310-825-5358
Fax Number	:	310-825-0884

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

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	12/23/2019

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Directions to “ DAVID C. CHEN M.D.” Practice Location

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