Healthcare Provider Details

I. General information

NPI: 1417171505
Provider Name (Legal Business Name): WAYNE W CHEN MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WEIPIN CHEN

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 CAMPUS DRIVE US LABS
IRVINE CA
92612
US

IV. Provider business mailing address

30 VIA LUCCA F209
IRVINE CA
92612
US

V. Phone/Fax

Practice location:
  • Phone: 949-754-9389
  • Fax: 949-754-9330
Mailing address:
  • Phone: 949-754-9389
  • Fax: 949-754-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberA83106
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA83106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: