Healthcare Provider Details

I. General information

NPI: 1497732937
Provider Name (Legal Business Name): PEGGY CHEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 SOQUEL DR SUITE H
SANTA CRUZ CA
95065-1706
US

IV. Provider business mailing address

1658 SOQUEL DRIVE SUITE H
SANTA CRUZ CA
95065-1706
US

V. Phone/Fax

Practice location:
  • Phone: 831-464-7000
  • Fax: 831-464-7001
Mailing address:
  • Phone: 831-464-7000
  • Fax: 831-464-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberA68794
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA68794
License Number StateCA

VIII. Authorized Official

Name: PEGGY CHI CHEN
Title or Position: PRESIDENT OF PEGGY CHEN MD INC
Credential: MD
Phone: 831-464-7000