Healthcare Provider Details

I. General information

NPI: 1609012129
Provider Name (Legal Business Name): CHEN I CHEN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 SHEFFIELD RD
SAN MARINO CA
91108-3031
US

IV. Provider business mailing address

2921 SHEFFIELD RD
SAN MARINO CA
91108-3031
US

V. Phone/Fax

Practice location:
  • Phone: 626-309-9899
  • Fax:
Mailing address:
  • Phone: 626-309-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number61539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: