Provider Demographics
NPI:1073527099
Name:CHEN, ANTHONY C (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:C
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1850 S AZUSA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6827
Mailing Address - Country:US
Mailing Address - Phone:626-912-2682
Mailing Address - Fax:626-912-2684
Practice Address - Street 1:1850 S AZUSA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6827
Practice Address - Country:US
Practice Address - Phone:626-912-2682
Practice Address - Fax:626-912-2684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG074781207R00000X
CAG74781207R00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F60277Medicare UPIN
G74781Medicare UPIN