Provider Demographics
NPI:1215010046
Name:ERIC Y. CHEN DPM CORP.
Entity Type:Organization
Organization Name:ERIC Y. CHEN DPM CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:YEN-JEN
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:626-965-1550
Mailing Address - Street 1:1661 HANOVER RD
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1796
Mailing Address - Country:US
Mailing Address - Phone:626-965-1550
Mailing Address - Fax:626-581-8411
Practice Address - Street 1:1661 HANOVER RD
Practice Address - Street 2:SUITE # 103
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1796
Practice Address - Country:US
Practice Address - Phone:626-965-1550
Practice Address - Fax:626-581-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4285213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty