MEDICARE: DR. CANDICE YEE CHEN DDS

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	1223G0001X	General Practice Dentistry	50406	CA

General Provider Information

NPI Number	:	1881754489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CANDICE YEE CHEN DDS

Provider Business Mailing Address
First Line	:	12251 ECKLESON PL
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-7660
Country	:	US
Telephone Number	:	916-719-5986
Fax Number	:

Provider Business Practice Location Address
First Line	:	20147 PIONEER BLVD
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90715-1051
Country	:	US
Telephone Number	:	916-719-5986
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	09/28/2015

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