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General NPI Number Information
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NPI Number | 1750845392
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Entity Type | Individual
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Provider Name | MATTHEW CHEN
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Gender | Male
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 11/10/2024
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Provider Practice Location Address
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Address Line | 900 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92521
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Country | US
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Telephone | 951-827-3813
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Fax |
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Provider Business Mailing Address
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Address Line | 900 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92521-6322
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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