Healthcare Provider Details

I. General information

NPI: 1396846432
Provider Name (Legal Business Name): WEBER CHEN MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 HUNTINGTON DR STE C
SOUTH PASADENA CA
91030-4859
US

IV. Provider business mailing address

1936 HUNTINGTON DR STE C
SOUTH PASADENA CA
91030-4859
US

V. Phone/Fax

Practice location:
  • Phone: 606-288-0008
  • Fax: 866-741-4630
Mailing address:
  • Phone: 606-288-0008
  • Fax: 866-741-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA85444
License Number StateCA

VIII. Authorized Official

Name: DR. WEBER CHEN
Title or Position: PHYSICIAN / OWNER
Credential: M.D.
Phone: 626-288-0008