Provider Demographics
NPI:1053451609
Name:CHEN, JASON CHAO PING (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CHAO PING
Last Name:CHEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 S ISABELLA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5530
Mailing Address - Country:US
Mailing Address - Phone:323-365-3845
Mailing Address - Fax:
Practice Address - Street 1:11600 WILSHIRE BLVD
Practice Address - Street 2:222
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5781
Practice Address - Country:US
Practice Address - Phone:310-477-8622
Practice Address - Fax:310-479-8238
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT32977AMedicare PIN