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General NPI Number Information
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NPI Number | 1952458887
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Entity Type | Organization
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Legal Business Name | ISAAC CHEN DENTAL PRACTICE INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 4410 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-1531
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Country | US
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Telephone | 323-881-0881
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Fax | 323-881-0800
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Provider Business Mailing Address
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Address Line | 4410 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-1531
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Country | US
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Telephone | 323-881-0881
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Fax | 323-881-0800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISAAC CHEN
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Credential | D.D.S.
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Telephone | 626-574-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36069
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License Number State | CA
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