Healthcare Provider Details

I. General information

NPI: 1710278544
Provider Name (Legal Business Name): EILEEN CHEN WONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EILEEN CHEN M.D.

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE BLDG 2
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

1501 N CAMPBELL AVE FL 6
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax:
Mailing address:
  • Phone: 520-621-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number59484
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: