Healthcare Provider Details

I. General information

NPI: 1033127402
Provider Name (Legal Business Name): MARIAN CHONG-MEI TZENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S ATLANTIC BLVD STE 3
MONTEREY PARK CA
91754-6340
US

IV. Provider business mailing address

1725 S EL MOLINO AVE
SAN MARINO CA
91108-1703
US

V. Phone/Fax

Practice location:
  • Phone: 323-721-0084
  • Fax:
Mailing address:
  • Phone: 626-799-6931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA35999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: