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NPI Code Detail

MEDICARE: JEFF TAI LI CHEN DR

MEDICARE: JEFF TAI LI CHEN DR
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
1207P00000XEmergency Medicine PhysicianA90900CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912973074
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFF TAI LI CHEN DR
Provider Business Mailing Address
First Line : 4301 NORTH STAR WAY
Second Line :
City : MODESTO
State : CA
Zip : 95356-9262
Country : US
Telephone Number : 209-342-2300
Fax Number : 209-342-2300
Provider Business Practice Location Address
First Line : 2450 ASHBY AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2067
Country : US
Telephone Number : 510-204-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 09/17/2012

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