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General NPI Number Information
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NPI Number | 1861766255
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Entity Type | Organization
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Legal Business Name | EAST BAY CARDIOLOGY INC
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 39229 LIBERTY STREET
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City | FREMONT
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State | CA
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Zip | 94538-1501
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Country | US
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Telephone | 510-494-8316
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Fax | 510-494-8314
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Provider Business Mailing Address
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Address Line | 39229 LIBERTY ST
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City | FREMONT
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State | CA
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Zip | 94538-1501
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Country | US
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Telephone | 510-494-8316
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Fax | 510-494-8314
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Authorized Official
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Title or Position | OWNER
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Name | DR. KWAN SIAN CHEN
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Credential | MD
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Telephone | 510-494-8316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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