Provider Demographics
NPI:1154081214
Name:CHEN, STEVEN CHUN AN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHUN AN
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 HALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-0600
Mailing Address - Country:US
Mailing Address - Phone:949-612-5798
Mailing Address - Fax:
Practice Address - Street 1:638 HALLEY DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-0600
Practice Address - Country:US
Practice Address - Phone:949-612-5798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy