Provider Demographics
NPI:1043201999
Name:CHEN, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
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 1:20100 N 51ST AVE
Mailing Address - Street 2:SUITE E-570
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5125
Mailing Address - Country:US
Mailing Address - Phone:602-993-9100
Mailing Address - Fax:602-993-5065
Practice Address - Street 1:20100 N 51ST AVE
Practice Address - Street 2:SUITE E-570
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5090
Practice Address - Country:US
Practice Address - Phone:602-993-9100
Practice Address - Fax:602-993-5065
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25627207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ393645Medicaid
AZ77316Medicare ID - Type Unspecified
AZ393645Medicaid