Healthcare Provider Details

I. General information

NPI: 1538521653
Provider Name (Legal Business Name): DAVID CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 STONERIDGE DR
PLEASANTON CA
94588-4501
US

IV. Provider business mailing address

420 EDINBURGH CIR
DANVILLE CA
94526-2900
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5100
  • Fax:
Mailing address:
  • Phone: 925-913-0197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA157084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: