MEDICARE: DR. CHRISTINA LYDIA CHEN DO

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	207RR0500X	Rheumatology Physician	20A13361	CA

General Provider Information

NPI Number	:	1952661829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA LYDIA CHEN DO

Provider Business Mailing Address
First Line	:	500 W SAN BERNARDINO RD STE A
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-3797
Country	:	US
Telephone Number	:	626-966-1909
Fax Number	:	626-209-0331

Provider Business Practice Location Address
First Line	:	500 W SAN BERNARDINO RD STE A
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-3797
Country	:	US
Telephone Number	:	626-966-1909
Fax Number	:	626-209-0331

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

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	07/13/2017

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