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General NPI Number Information
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NPI Number | 1588826259
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Entity Type | Organization
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Legal Business Name | EUGENE D. CHEN, MD. PLLC
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 1925 E ORMAN AVE
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City | PUEBLO
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State | CO
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Zip | 81004-3537
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Country | US
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Telephone | 808-281-7776
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Fax | 580-379-6659
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Provider Business Mailing Address
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Address Line | PO BOX 2101
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City | PUEBLO
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State | CO
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Zip | 81004-0101
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Country | US
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Telephone | 808-281-7776
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Fax | 580-379-6659
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE DUNYO CHEN
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Credential | MD
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Telephone | 808-281-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 46298
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License Number State | CO
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