Healthcare Provider Details

I. General information

NPI: 1336160191
Provider Name (Legal Business Name): TZEN KUANG CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720
US

IV. Provider business mailing address

PO BOX 26750
FRESNO CA
93729-6750
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-5360
  • Fax: 559-449-3347
Mailing address:
  • Phone: 559-455-4000
  • Fax: 559-455-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberA31949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: