Healthcare Provider Details

I. General information

NPI: 1659698298
Provider Name (Legal Business Name): AUSTIN WARREN CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 PEARL PKWY STE 200
BOULDER CO
80301-3080
US

IV. Provider business mailing address

4740 PEARL PKWY STE 200
BOULDER CO
80301-3080
US

V. Phone/Fax

Practice location:
  • Phone: 303-449-2730
  • Fax: 303-449-5821
Mailing address:
  • Phone: 303-449-2730
  • Fax: 303-449-5821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number036140589
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD2015-0287
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberDR.0059216
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: