Healthcare Provider Details

I. General information

NPI: 1992365837
Provider Name (Legal Business Name): RYAN CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 COLUMBUS AVE BAY CITY
BAY CITY MI
48708-6880
US

IV. Provider business mailing address

2836 VIOLET DR
SAN JACINTO CA
92582-3737
US

V. Phone/Fax

Practice location:
  • Phone: 989-894-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA203503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: