Healthcare Provider Details

I. General information

NPI: 1306426416
Provider Name (Legal Business Name): CHEN MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SHORELINE HIGHWAY BUILDING B SUITE 100-1020
MILL VALLEY CA
94941
US

IV. Provider business mailing address

100 SHORELINE HIGHWAY BUILDING B SUITE 100-1020
MILL VALLEY CA
94941
US

V. Phone/Fax

Practice location:
  • Phone: 213-534-7330
  • Fax:
Mailing address:
  • Phone: 213-534-7330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YU CHIA CHEN
Title or Position: DIRECTOR/CEO
Credential: MD
Phone: 213-534-7330