Healthcare Provider Details

I. General information

NPI: 1851603674
Provider Name (Legal Business Name): CHRISTOPHER CHUN MAN CHEN MD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 W SAINT MARYS RD STE 275
TUCSON AZ
85745-2629
US

IV. Provider business mailing address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

V. Phone/Fax

Practice location:
  • Phone: 520-276-2270
  • Fax: 520-585-5827
Mailing address:
  • Phone: 562-735-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberT6765
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number22291
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMC-2460
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number47422
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: