Healthcare Provider Details

I. General information

NPI: 1689266165
Provider Name (Legal Business Name): CHEN AND LEE A PROFESSIONAL MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 W BEVERLY BLVD STE 303
MONTEBELLO CA
90640-3951
US

IV. Provider business mailing address

1142 S DIAMOND BAR BLVD STE 688
DIAMOND BAR CA
91765-2203
US

V. Phone/Fax

Practice location:
  • Phone: 626-463-8162
  • Fax:
Mailing address:
  • Phone: 626-463-8162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL C CHEN
Title or Position: OWNER
Credential: MD, PHD
Phone: 626-463-8162