Healthcare Provider Details

I. General information

NPI: 1982182127
Provider Name (Legal Business Name): HARRY CHEN, M.D., INC., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 N 6TH ST
FOWLER CA
93625
US

IV. Provider business mailing address

128 N 6TH ST
FOWLER CA
93625-2332
US

V. Phone/Fax

Practice location:
  • Phone: 559-676-3975
  • Fax: 559-676-3974
Mailing address:
  • Phone: 559-676-3975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HARRY CHEN
Title or Position: OWNER/ CEO
Credential: M.D.
Phone: 559-676-3975