Healthcare Provider Details

I. General information

NPI: 1700223419
Provider Name (Legal Business Name): SUZY CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST ROOM 245
OAKLAND CA
94609
US

IV. Provider business mailing address

747 52ND ST ROOM 245
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3331
  • Fax: 510-601-3979
Mailing address:
  • Phone: 510-428-3331
  • Fax: 510-601-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA145341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: