MEDICARE: JIAN CHEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	A179668	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	XEK905594891	OTHER		BLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number	:	1093379182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIAN CHEN MD

Provider Business Mailing Address
First Line	:	1200 N STATE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:	626-650-7931
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N STATE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:	626-650-7931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2019
Last Update Date	:	05/14/2026

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