Provider Demographics
NPI:1124565429
Name:CHEN MD & ASSOCIATES
Entity Type:Organization
Organization Name:CHEN MD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-461-2840
Mailing Address - Street 1:4439 STONERIDGE DR
Mailing Address - Street 2:STE 130
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8314
Mailing Address - Country:US
Mailing Address - Phone:925-461-2840
Mailing Address - Fax:
Practice Address - Street 1:4439 STONERIDGE DR
Practice Address - Street 2:STE 130
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8314
Practice Address - Country:US
Practice Address - Phone:925-461-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63956261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care