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General NPI Number Information
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NPI Number | 1811299175
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Entity Type | Organization
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Legal Business Name | FULTON CHEN MD INC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 1999 MOWRY AVE STE S
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City | FREMONT
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State | CA
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Zip | 94538-1723
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Country | US
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Telephone | 510-739-1922
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Fax | 510-739-1925
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Provider Business Mailing Address
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Address Line | 1999 MOWRY AVE SUITE S
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City | FREMONT
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State | CA
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Zip | 94538-1738
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Country | US
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Telephone | 510-739-1922
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Fax | 510-739-1925
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FULTON SHEEN CHEN
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Credential | MD
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Telephone | 510-739-1922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A55609
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License Number State | CA
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