Provider Demographics
NPI:1003829326
Name:CHEN, ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 CADILLAC AVE
Mailing Address - Street 2:INTERNAL MEDICINE MODULE 2D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1702
Mailing Address - Country:US
Mailing Address - Phone:323-857-3303
Mailing Address - Fax:323-857-2929
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:INTERNAL MEDICINE MODULE 2D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-3303
Practice Address - Fax:323-857-2929
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA065639OtherMEDICAL LIC#
CAG96968Medicare UPIN