Healthcare Provider Details

I. General information

NPI: 1699578732
Provider Name (Legal Business Name): TIFFANY YOULING CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 O'CONNOR DRIVE #250
SAN JOSE CA
95128
US

IV. Provider business mailing address

455 O'CONNOR DRIVE #250
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-283-7676
  • Fax: 408-283-7646
Mailing address:
  • Phone: 408-283-7676
  • Fax: 408-283-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: