Healthcare Provider Details

I. General information

NPI: 1972681948
Provider Name (Legal Business Name): HUNG I CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 E 17TH ST N354
SANTA ANA CA
92701
US

IV. Provider business mailing address

1125 E 17TH ST #N354
SANTA ANA CA
92701
US

V. Phone/Fax

Practice location:
  • Phone: 714-569-0388
  • Fax: 714-569-1018
Mailing address:
  • Phone: 714-569-0388
  • Fax: 714-569-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA33013
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA33013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: