Healthcare Provider Details

I. General information

NPI: 1821890310
Provider Name (Legal Business Name): PATRICK MA CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 SHATTUCK AVE
BERKELEY CA
94709-1411
US

IV. Provider business mailing address

2132 16TH AVE
SAN FRANCISCO CA
94116-1845
US

V. Phone/Fax

Practice location:
  • Phone: 510-542-5242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: