Healthcare Provider Details

I. General information

NPI: 1942386180
Provider Name (Legal Business Name): WILLIAM W CHEN MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 VALE RD # 34
SAN PABLO CA
94806
US

IV. Provider business mailing address

2089 VALE RD # 34
SAN PABLO CA
94806
US

V. Phone/Fax

Practice location:
  • Phone: 510-235-9247
  • Fax: 510-235-9248
Mailing address:
  • Phone: 510-235-9247
  • Fax: 510-235-9248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM WEI MING CHEN
Title or Position: PRESIDENT
Credential: MD
Phone: 510-235-9247