Healthcare Provider Details

I. General information

NPI: 1972131431
Provider Name (Legal Business Name): REBECCA CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 HIGH ST
PALO ALTO CA
94301-1043
US

IV. Provider business mailing address

301 HIGH ST
PALO ALTO CA
94301-1043
US

V. Phone/Fax

Practice location:
  • Phone: 650-969-5600
  • Fax: 650-969-0360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA197000
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA197000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: