Healthcare Provider Details

I. General information

NPI: 1285347377
Provider Name (Legal Business Name): TAMMY M CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 BREA CANYON RD
DIAMOND BAR CA
91789-3059
US

IV. Provider business mailing address

3535 PHILADELPHIA ST
CHINO CA
91710-2089
US

V. Phone/Fax

Practice location:
  • Phone: 909-594-3382
  • Fax: 626-667-7633
Mailing address:
  • Phone: 909-851-0876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: