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General NPI Number Information
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NPI Number | 1457189714
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Entity Type | Individual
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Provider Name | NICOLE CHEN
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Gender | Female
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 1680 E 120TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90059-3026
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Country | US
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Telephone | 424-338-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 437 S HILL ST APT 708
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City | LOS ANGELES
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State | CA
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Zip | 90013-2758
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT0015344
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH240088
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH06251
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH86200
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License Number State | CA
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