Provider Demographics
NPI:1275710980
Name:CHEN, PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14621
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91409-4621
Mailing Address - Country:US
Mailing Address - Phone:818-876-2989
Mailing Address - Fax:
Practice Address - Street 1:15840 VENTURA BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2932
Practice Address - Country:US
Practice Address - Phone:818-876-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01100111N00000X
CA29612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor