Healthcare Provider Details

I. General information

NPI: 1811312291
Provider Name (Legal Business Name): YUANYUAN CHEN M.D. MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date: 09/25/2014
Reactivation Date: 03/04/2015

III. Provider practice location address

202-1333 WEST 11TH AVE
VANCOUVER BC
VGH 0H4
CA

IV. Provider business mailing address

215 E 95TH STREET 23B
NEW YORK NY
10128
US

V. Phone/Fax

Practice location:
  • Phone: 778-990-7820
  • Fax:
Mailing address:
  • Phone: 718-974-6418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: