Healthcare Provider Details

I. General information

NPI: 1902731912
Provider Name (Legal Business Name): PAUL CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 W BENCAMP ST
SAN GABRIEL CA
91776-3718
US

IV. Provider business mailing address

507 W BENCAMP ST
SAN GABRIEL CA
91776-3718
US

V. Phone/Fax

Practice location:
  • Phone: 626-782-1846
  • Fax:
Mailing address:
  • Phone: 626-782-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number34688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: