Provider Demographics
NPI:1144754623
Name:CHEN, REBECCA IRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:IRIS
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4860 Y ST STE 2400
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-6891
Mailing Address - Fax:916-734-6197
Practice Address - Street 1:4860 Y ST STE 2400
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6891
Practice Address - Fax:916-734-6197
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.029367207W00000X
FLME150084207W00000X
CAA179153207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME150084OtherFLORIDA MEDICAL LICENSE
CAA179153OtherCALIFORNIA MEDICAL LICENSE