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NPI 1124018171

NPI 1124018171 : CHIA CHEN MD : EUREKA, CA

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General NPI Number Information
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    NPI Number           |    1124018171
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    Entity Type          |    Individual 
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    Provider Name        |    CHIA CHEN MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/21/2005
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    Last Update Date     |    12/05/2011
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Provider Practice Location Address
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    Address Line         |    2350 BUHNE ST A
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-3238
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    Country              |    US
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    Telephone            |    707-443-4593
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    Fax                  |    707-443-6447
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Provider Business Mailing Address
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    Address Line         |    2350 BUHNE ST A
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-3238
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    Country              |    US
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    Telephone            |    707-443-4593
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    Fax                  |    707-443-6447
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    173000000X
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    Taxonomy Name        |    Legal Medicine
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    License Number       |    A61881
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    License Number State |    CA
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