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NPI Code Detail

MEDICARE: DR. YUAN CHEN OD

MEDICARE: DR. YUAN CHEN OD
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
1152W00000XOptometrist3807TN
2152W00000XOptometristOPT-002907AZ

General Provider Information

NPI Number : 1558055251
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YUAN CHEN OD
Provider Business Mailing Address
First Line : 955 W SOUTHERN AVE STE 101
Second Line :
City : MESA
State : AZ
Zip : 85210-4903
Country : US
Telephone Number : 480-961-1865
Fax Number : 480-893-8172
Provider Business Practice Location Address
First Line : 3788 S 16TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6079
Country : US
Telephone Number : 520-388-9741
Fax Number : 520-388-9750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2023
Last Update Date : 09/19/2025

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