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NPI Code Detail

MEDICARE: FELICIA KANG CHEN O.D.

MEDICARE: FELICIA KANG CHEN O.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
1152W00000XOptometrist12590TCA

General Provider Information

NPI Number : 1386769362
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICIA KANG CHEN O.D.
Provider Business Mailing Address
First Line : 285 W. 6TH STREET #503
Second Line :
City : SAN PEDRO
State : CA
Zip : 90731
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3329 TWEEDY BLVD
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-4324
Country : US
Telephone Number : 323-566-6183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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Directions to “ FELICIA KANG CHEN O.D.” Practice Location

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