Healthcare Provider Details

I. General information

NPI: 1114284478
Provider Name (Legal Business Name): YI-REN CHEN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 J ST STE 250
SACRAMENTO CA
95819-3637
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-3401
  • Fax: 916-733-3410
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA126433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: