Provider Demographics
NPI:1154640076
Name:TOMMY H CHEN MD INC DERMATOLOGY
Entity Type:Organization
Organization Name:TOMMY H CHEN MD INC DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-793-4857
Mailing Address - Street 1:50 BELLEFONTAINE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3132
Mailing Address - Country:US
Mailing Address - Phone:626-793-4857
Mailing Address - Fax:626-793-8812
Practice Address - Street 1:12522 LAMBERT RD
Practice Address - Street 2:SUITE B
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2758
Practice Address - Country:US
Practice Address - Phone:562-789-8886
Practice Address - Fax:562-789-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37340207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC37340OtherPTAN