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General NPI Number Information
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NPI Number | 1083904254
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Entity Type | Organization
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Legal Business Name | CHING CHEN M D INCORPORATED
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 17170 COLIMA RD SUITE #E
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-6771
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Country | US
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Telephone | 626-810-5601
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Fax | 626-810-2556
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Provider Business Mailing Address
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Address Line | 17170 COLIMA RD SUITE #E
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-6771
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Country | US
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Telephone | 626-810-5601
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Fax | 626-810-2556
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Authorized Official
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Title or Position | PHD
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Name | MRS. CHING HSIU CHEN
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Credential | M D
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Telephone | 626-810-5601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | G65094
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License Number State | CA
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