Healthcare Provider Details

I. General information

NPI: 1205276458
Provider Name (Legal Business Name): JARREAU CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # FE10
MADERA CA
93636-8762
US

IV. Provider business mailing address

12500 STOCKDAY HWY
BAKERSFIELD CA
93314
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5941
  • Fax: 559-353-5945
Mailing address:
  • Phone: 616-564-3300
  • Fax: 616-564-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number286033
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number286033
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number155889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: