MEDICARE: DR. BEIRU J. 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	207ZB0001X	Blood Banking & Transfusion Medicine Physician	C51848	CA
2	207ZC0500X	Cytopathology Physician	C51848	CA
3	207ZD0900X	Dermatopathology (Pathology) Physician	C51848	CA
4	207ZH0000X	Hematology (Pathology) Physician	C51848	CA
5	207ZI0100X	Immunopathology Physician	C51848	CA
6	207ZM0300X	Medical Microbiology Physician	C51848	CA
7	207ZN0500X	Neuropathology Physician	C51848	CA
8	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	C51848	CA
9	207ZP0104X	Chemical Pathology Physician	C51848	CA
10	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	C51848	CA
11	207ZP0213X	Pediatric Pathology Physician	C51848	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BP693	OTHER	CA	MEDICARE PTAN
3	P00706349	OTHER	CA	MEDICARE RAILROAD PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1669694766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEIRU J. CHEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 77800
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95267-1100
Country	:	US
Telephone Number	:	209-477-4432
Fax Number	:	209-320-6136

Provider Business Practice Location Address
First Line	:	2291 W MARCH LN
Second Line	:	SUITE 179E
City	:	STOCKTON
State	:	CA
Zip	:	95207-6652
Country	:	US
Telephone Number	:	209-477-4432
Fax Number	:	209-320-6136

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	06/23/2009

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