MEDICARE: JAMES YNG JEN CHEN 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	207R00000X	Internal Medicine Physician	A86644	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265495691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES YNG JEN CHEN M.D.

Provider Business Mailing Address
First Line	:	11513 TRAILBROOK LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-6340
Country	:	US
Telephone Number	:	619-955-7783
Fax Number	:	619-793-4898

Provider Business Practice Location Address
First Line	:	11513 TRAILBROOK LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-6340
Country	:	US
Telephone Number	:	619-955-7783
Fax Number	:	619-793-4898

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	02/06/2025

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