Healthcare Provider Details

I. General information

NPI: 1457411704
Provider Name (Legal Business Name): JAMES JEFFREY CHIEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2006
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 S ELLSWORTH RD
MESA AZ
85212-2164
US

IV. Provider business mailing address

4650 E COTTON CENTER BLVD STE 250
PHOENIX AZ
85040-4806
US

V. Phone/Fax

Practice location:
  • Phone: 480-649-3111
  • Fax:
Mailing address:
  • Phone: 623-505-4847
  • Fax: 602-685-9595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number40347
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number231477
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number40347
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: