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General NPI Number Information
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NPI Number | 1720575871
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Entity Type | Individual
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Provider Name | WILLIAM CHEN DO
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Gender | Male
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Dates
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Enumeration Date | 04/15/2018
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 1001 W BROADWAY STE D&E
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City | FARMINGTON
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State | NM
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Zip | 87401-5638
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Country | US
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Telephone | 505-327-4796
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Fax | 505-599-9351
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Provider Business Mailing Address
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Address Line | 1001 W BROADWAY STE D&E
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City | FARMINGTON
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State | NM
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Zip | 87401-5638
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Country | US
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Telephone | 505-327-4796
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Fax | 505-599-9351
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A17902
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2024-0004
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License Number State | NM
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