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NPI Code Detail

MEDICARE: JACK CHEN

MEDICARE: JACK CHEN
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1972459626
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK CHEN
Provider Business Mailing Address
First Line : 647 W ROBINSON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-2855
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2309 TULARE ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-2287
Country : US
Telephone Number : 559-457-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “ JACK CHEN ” Practice Location

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