Healthcare Provider Details

I. General information

NPI: 1396734505
Provider Name (Legal Business Name): CHRISTOPHER J CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLBY ST SUITE 106
BERKELEY CA
94705-2058
US

IV. Provider business mailing address

3000 COLBY ST SUITE 106
BERKELEY CA
94705-2058
US

V. Phone/Fax

Practice location:
  • Phone: 510-647-1200
  • Fax: 510-647-1205
Mailing address:
  • Phone: 510-647-1200
  • Fax: 510-647-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA75341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: