MEDICARE: DR. CINDY CHEN JEN M.D.

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	207Q00000X	Family Medicine Physician	A118356	CA

General Provider Information

NPI Number	:	1104123199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY CHEN JEN M.D.

Provider Business Mailing Address
First Line	:	10861 CHERRY ST STE 105
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-5403
Country	:	US
Telephone Number	:	562-259-8881
Fax Number	:	562-259-8887

Provider Business Practice Location Address
First Line	:	10861 CHERRY ST STE 105
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-5403
Country	:	US
Telephone Number	:	562-259-8881
Fax Number	:	562-259-8887

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

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	02/25/2026

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