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General NPI Number Information
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NPI Number | 1871751115
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Entity Type | Organization
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Legal Business Name | JANA CHEN, O.D., APC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 4143 RIVERSIDE DR STE C
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City | CHINO
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State | CA
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Zip | 91710-3126
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Country | US
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Telephone | 909-591-5438
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Fax | 909-591-5432
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Provider Business Mailing Address
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Address Line | 4143 RIVERSIDE DR STE C
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City | CHINO
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State | CA
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Zip | 91710-3126
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Country | US
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Telephone | 909-591-5438
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Fax | 909-591-5432
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Authorized Official
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Title or Position | CEO
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Name | DR. JANA CHEN
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Credential | O.D.
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Telephone | 909-591-5438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT11618TPL
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License Number State | CA
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