Healthcare Provider Details

I. General information

NPI: 1275704371
Provider Name (Legal Business Name): HUI JIE JENNY CHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CRANE ST
MENLO PARK CA
94025-4260
US

IV. Provider business mailing address

1300 CRANE ST
MENLO PARK CA
94025-4260
US

V. Phone/Fax

Practice location:
  • Phone: 650-498-6530
  • Fax: 650-329-0586
Mailing address:
  • Phone: 650-498-6530
  • Fax: 650-329-0586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA98117
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA98117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: