Healthcare Provider Details
I. General information
NPI: 1518992981
Provider Name (Legal Business Name): ALLEN M CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/12/2006
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 THE CITY DR S
ORANGE CA
92868-3201
US
IV. Provider business mailing address
200 S MANCHESTER AVE STE 300
ORANGE CA
92868-3219
US
V. Phone/Fax
- Phone: 714-880-7812
- Fax:
- Phone: 714-456-2986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | A84562 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: