Healthcare Provider Details

I. General information

NPI: 1336883024
Provider Name (Legal Business Name): CLARA CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 WEBSTER ST
OAKLAND CA
94607-4219
US

IV. Provider business mailing address

835 WEBSTER ST
OAKLAND CA
94607-4219
US

V. Phone/Fax

Practice location:
  • Phone: 510-318-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD.MD.61679880
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: