Healthcare Provider Details

I. General information

NPI: 1083844179
Provider Name (Legal Business Name): STEPHEN SAM-FONG CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 03/07/2023
Certification Date: 11/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HIGHWAY
DOWNEY CA
90242-2812
US

IV. Provider business mailing address

9333 IMPERIAL HIGHWAY
DOWNEY CA
90242-2812
US

V. Phone/Fax

Practice location:
  • Phone: 562-657-9000
  • Fax:
Mailing address:
  • Phone: 800-823-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA108952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: