Provider Demographics
NPI:1245598838
Name:CHEN, JEN TUNG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEN TUNG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:751 S BASCOM AVE # BE034
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:408-885-2376
Mailing Address - Fax:408-885-2351
Practice Address - Street 1:751 S BASCOM AVE # BE034
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2604
Practice Address - Country:US
Practice Address - Phone:408-885-2376
Practice Address - Fax:408-885-2351
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy