MEDICARE: DR. JOE MEANNAN 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	207RG0100X	Gastroenterology Physician	G70529	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	:	1700817350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOE MEANNAN CHEN M.D.

Provider Business Mailing Address
First Line	:	10861 CHERRY STREET
Second Line	:	SUITE 302
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-5403
Country	:	US
Telephone Number	:	562-493-1011
Fax Number	:	562-594-9223

Provider Business Practice Location Address
First Line	:	10861 CHERRY STREET
Second Line	:	SUITE 302
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-5403
Country	:	US
Telephone Number	:	562-493-1011
Fax Number	:	562-594-9223

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	08/25/2015

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